Individual provider Active NPI

Lena Ravenell

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1215701594
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0012125 Issued in DE
Practice address
4755 Ogletown Stanton Road
Suite 5A43
Newark, DE 19718-2200
Phone
(302) 623-0188
Fax
(302) 733-5640
NPI assigned
Nov 8, 2023
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0009681 MD
Physician Assistant 363A00000X C5-0012125 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Road
Suite 5A43
Newark, DE 19718-2200

Mailing address

6607 Lake Hill Dr Apt H
Raleigh, NC 27609-3424

Other practice location 1

6607 Lake Hill Dr Apt H
Raleigh, NC 27609-3424
Phone (302) 559-8266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241223000449 DE Practitioner - Physician Assistant 1759818248 Reassigns benefits to 1 organization
I20250116000945 MD Practitioner - Physician Assistant 1759818248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 623-0188

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0009681MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Jan 6, 2025 Accepting new patients
Christiana Care Health Services Inc CurrentSince Dec 17, 2024 Accepting new patients
Union Hospital of Cecil County, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Christiana Care Health Services Inc CurrentSince Dec 17, 2024 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Ste 5A43
Newark, DE 19718
Phone (302) 623-0188

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

4000 Nexus Dr
Ste E3
Wilmington, DE 19803

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1215701594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6607 LAKE HILL DR APT H",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON ROAD",
            "address_2": "SUITE 5A43",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-623-0188",
            "fax_number": "302-733-5640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6607 Lake Hill Dr Apt H",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276093424",
            "country_code": "US",
            "telephone_number": "302-559-8266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVENELL",
        "first_name": "LENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009681",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0012125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.