NPIMap

Individual provider Active NPI

Jed Nieves, CRNP

  • Nurse Practitioner
  • Williamsport, PA
National Provider Identifier
1336615897
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP031316 Issued in PA
Practice address
700 High Street
Williamsport, PA 17701-3100
Phone
(570) 321-2020
NPI assigned
Oct 22, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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 SP031316 PA Primary

Addresses

Primary practice location

700 High Street
Williamsport, PA 17701-3100

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone (570) 326-8723

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jed.t.nieves@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190226002830 MD Practitioner - Nurse Practitioner 3779822309 Reassigns benefits to 4 organizations
I20241230000148 PA Practitioner - Nurse Practitioner 3779822309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians
Carroll Arthritis LLCGroup PAC ID 6406289586, 4 clinicians

Practice addresses (Care Compare)

1201 Grampian Blvd
Williamsport, PA 17701-1965

416 S Main St
Mansfield, PA 16933-1510

531 Old Westminster Pike
Suite 202
Westminster, MD 21157-6276
Phone (410) 848-0364

700 High St
Williamsport, PA 17701-3100

700 High St
Williamsport, PA 17701-3198

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Orthopaedic Associates P a CurrentSince Feb 1, 2019 Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Oct 1, 2020 Accepting new patients
Susquehanna Physician Services Nurse Practitioner Current Accepting new patients
Susquehanna Physician Services Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
University of Maryland Orthopaedic Associates PA CurrentSince Feb 1, 2019 Accepting new patients
Susquehanna Physician Services CurrentSince Jan 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

110 S Paca St
#38
Baltimore, MD 21201

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

1201 Grampian Blvd
Ste 2F
Williamsport, PA 17701
Phone (570) 320-7598

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Interoperability endpoints

  • Direct secure messaging: jnieves299215@direct.umm.edu
  • Direct secure messaging: jnieves515094@upmc.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1336615897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "570-326-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGH STREET",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013100",
            "telephone_number": "570-321-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "JED",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP031316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jed.t.nieves@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.