Individual provider Active NPI

Cresencia E Leopold, ANP

  • Gerontology Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1225642200
Registry record updated Sep 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ01026300 Issued in NJ
Practice address
201 Lyons Ave
Newark, NJ 07112-2027
Phone
(973) 868-2983
NPI assigned
Sep 7, 2020
Last updated
Sep 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ01026300 NJ Primary

Addresses

Primary practice location

201 Lyons Ave
Newark, NJ 07112-2027

Mailing address

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 868-2983

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
I20260521003634 NJ Practitioner - Nurse Practitioner 5890265623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 W Gilbert St
Tinton Falls, NJ 07701-4948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ01026300NJMDGerontology Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: cleopold230171@epicdirect.rwjbh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599436800000",
    "number": "1225642200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-868-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-868-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEOPOLD",
        "first_name": "CRESENCIA",
        "middle_name": "E",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ01026300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.