Individual provider Active NPI

Alicia Travis Rengert, CRNP

  • Family Nurse Practitioner
  • Cary, NC
National Provider Identifier
1225307689
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5009943 Issued in NC
Practice address
100 Cornerstone Dr
Cary, NC 27519-8453
Phone
(919) 650-3660
NPI assigned
Dec 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5009943 NC Primary

Addresses

Primary practice location

100 Cornerstone Dr
Cary, NC 27519-8453

Mailing address

100 Cornerstone Dr
Cary, NC 27519-8453

Other practice location 1

250 King Of Prussia Rd
Suite 2J
Radnor, PA 19087-5220
Phone (610) 902-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220324000757 PA Practitioner - Nurse Practitioner 3173881133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1800 Lombard St
Suite 206
Philadelphia, PA 19146-1414
Phone (215) 615-2222

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Apr 11, 2022 Accepting new patients
University of Penn - Medical Group CurrentSince Apr 11, 2022 Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

1800 Lombard St
Ste 206
Philadelphia, PA 19146
Phone (215) 615-2222

250 King of Prussia Rd
Ste 2J
Radnor, PA 19087
Phone (610) 902-2450

Organizations & group practices 2

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": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1225307689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORNERSTONE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275198453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CORNERSTONE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275198453",
            "telephone_number": "919-650-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 King Of Prussia Rd",
            "address_2": "Suite 2J",
            "address_purpose": "LOCATION",
            "city": "Radnor",
            "state": "PA",
            "postal_code": "190875220",
            "country_code": "US",
            "telephone_number": "610-902-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENGERT",
        "first_name": "ALICIA",
        "middle_name": "TRAVIS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.