Individual provider Active NPI

Marie Renzi, FNP-BC

  • Nurse Practitioner
  • Milford, DE
National Provider Identifier
1295081834
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0000626 Issued in DE
Practice address
201 W Liberty Way
Milford, DE 19963-5399
Phone
(302) 424-3694
Fax
(302) 424-3697
NPI assigned
Aug 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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 LG-0000626 DE Primary

Addresses

Primary practice location

201 W Liberty Way
Milford, DE 19963-5399

Mailing address

4923 Ogletown Stanton Rd
Suite 200
Newark, DE 19713-2081
Phone (302) 225-0451

Other identifiers 1

IdentifierTypeStateIssuer
1295081834MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA2 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
I20121019000565 DE Practitioner - Nurse Practitioner 3577713965 Reassigns benefits to 1 organization
I20231204000230 PA Practitioner - Nurse Practitioner 3577713965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
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)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127

3400 Civic Ctr Blvd 2ND FLR W
Advanced Internal Med
Philadelphia, PA 19104-5127
Phone (215) 615-5252

3801 Filbert St Mab
102 Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9436

51 N 39TH Street Mab
Philadelphia, PA 19104-2640
Phone (215) 662-9990

51 N 39TH Stret
Hospital Med Presby
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LG-0000626DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Current Accepting new patients
University of Penn - Medical Group CurrentSince Nov 26, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Nov 26, 2023 Accepting new patients
Atlantic General Hospital Corporation Nurse Practitioner Past Accepting new patients

Locations

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

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

Interoperability endpoints

  • Direct secure messaging: marierenzi@agh.allscriptsdirect.net

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 2

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": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1295081834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 OGLETOWN STANTON RD",
            "address_2": "SUITE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132081",
            "telephone_number": "302-225-0451",
            "fax_number": "302-225-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W LIBERTY WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199635399",
            "telephone_number": "302-424-3694",
            "fax_number": "302-424-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZI",
        "first_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0000626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295081834",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.