NPIMap

Individual provider Active NPI

Jenna Marie Pietrucha

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1386369130
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01377900 Issued in NJ
Practice address
801 Spruce St
Philadelphia, PA 19107-5701
Phone
(215) 316-5151
NPI assigned
Oct 4, 2022
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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 26NJ01377900 NJ Primary

Addresses

Primary practice location

801 Spruce St
Philadelphia, PA 19107-5701

Mailing address

733 Route 70 E
Marlton, NJ 08053

Other practice location 1

3157 Almond St
Philadelphia, PA 19134-5116
Phone (267) 879-7476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, 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
I20221021000058 NJ Practitioner - Nurse Practitioner 7416323126 Reassigns benefits to 3 organizations
I20230415000049 PA Practitioner - Nurse Practitioner 7416323126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-3487

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01377900NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Oct 10, 2023 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Oct 10, 2023 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Clinical Health Care Associates of New Jersey PC CurrentSince Oct 10, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2023 Accepting new patients
Thomas J Marzili MD LLC CurrentSince Oct 5, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2023 Accepting new patients

Locations

1865 Route 70 E
Ste 130
Cherry Hill, NJ 08003
Phone (856) 433-2535

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

733 Route 70 E
Bldg 2
Marlton, NJ 08053

733 Route 70 E
Ste 201
Marlton, NJ 08053
Phone (609) 451-2020

5 Plainsboro Rd
Ste 300
Plainsboro, NJ 08536

1006 Mantua Pike
Spc Care
Woodbury, NJ 08097
Phone (856) 845-8600

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

801 Spruce St
Philadelphia, PA 19107
Phone (215) 829-3396

801 Spruce St
Fl 3
Philadelphia, PA 19107
Phone (215) 627-5272

Organizations & group practices 8

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1386369130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 ROUTE 70 E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075701",
            "telephone_number": "215-316-5151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3157 Almond St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191345116",
            "country_code": "US",
            "telephone_number": "267-879-7476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIETRUCHA",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01377900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.