Individual provider Active NPI

Luz D Rodriguez Pena, FNP

  • Family Nurse Practitioner
  • Union, NJ
National Provider Identifier
1336965482
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ15214400 Issued in NJ
Practice address
978 Potter Ave
Union, NJ 07083-7622
Phone
(973) 699-5452
NPI assigned
Nov 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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 26NJ15214400 NJ Primary

Addresses

Primary practice location

978 Potter Ave
Union, NJ 07083-7622

Mailing address

978 Potter Ave
Union, NJ 07083-7622
Phone (973) 699-5452

Other names 1

  • Luz D Rodriguez Other name

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
I20250325003393 NJ Practitioner - Nurse Practitioner 5799208203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serenity Hospice Care, LLCGroup PAC ID 5092988089, 10 clinicians

Practice addresses (Care Compare)

56 Georgetown Rd
Bordentown, NJ 08505-2405
Phone (609) 227-2400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15214400NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Hospice Care, LLC CurrentSince Jun 12, 2025 Accepting new patients
Medical Associates of Englewood, PC CurrentSince May 1, 2025 Accepting new patients
Saleh I Khaddash MD PA CurrentSince May 1, 2025 Accepting new patients

Locations

56 Georgetown Rd
Bordentown, NJ 08505
Phone (609) 227-2400

969 Paulison Ave
Clifton, NJ 07011
Phone (973) 546-3355

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

Organizations & group practices 3

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": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1336965482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "978 POTTER AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837622",
            "telephone_number": "973-699-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "978 POTTER AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837622",
            "telephone_number": "973-699-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ PENA",
        "first_name": "LUZ",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15214400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUZ",
            "last_name": "RODRIGUEZ",
            "middle_name": "D",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.