Individual provider Active NPI

Lauren Ann Letizia, APN

  • Nurse Practitioner
  • Wayne, NJ
National Provider Identifier
1215397377
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00624500 Issued in NJ
Practice address
246 Hamburg Tpke
Suite 207
Wayne, NJ 07470-2156
Phone
(973) 653-3366
Fax
(973) 653-3665
NPI assigned
Mar 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00624500 NJ Primary

Addresses

Primary practice location

246 Hamburg Tpke
Suite 207
Wayne, NJ 07470-2156

Mailing address

246 Hamburg Tpke
Suite 207
Wayne, NJ 07470-2156
Phone (973) 653-3366

Other identifiers 1

IdentifierTypeStateIssuer
0507628MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160520000876 NJ Practitioner - Nurse Practitioner 7012206675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Jersey Nephrology Assoc. PAGroup PAC ID 7315908167, 15 clinicians

Practice addresses (Care Compare)

246 Hamburg Tpke
Suite 207
Wayne, NJ 07470-2160
Phone (973) 653-3366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00624500NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Jersey Nephrology Assoc. PA CurrentSince Apr 10, 2016 Accepting new patients

Locations

50 Mount Prospect Ave
Ste 101
Clifton, NJ 07013
Phone (973) 574-9880

764 Main St
Ste 301
Paterson, NJ 07503

230 W Parkway
Ste 10
Pompton Plns, NJ 07444
Phone (908) 442-7011

246 Hamburg Tpke
Ste 207
Wayne, NJ 07470
Phone (201) 796-1200

1031 McBride Ave
Ste D209
Woodland Park, NJ 07424
Phone (973) 222-8387

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1215397377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE",
            "address_2": "SUITE 207",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702156",
            "telephone_number": "973-653-3366",
            "fax_number": "973-653-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE",
            "address_2": "SUITE 207",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702156",
            "telephone_number": "973-653-3366",
            "fax_number": "973-653-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETIZIA",
        "first_name": "LAUREN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00624500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0507628",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.