Individual provider Active NPI

Jenill Rodriguez, APN

  • Family Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1497410195
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01198000 Issued in NJ
Practice address
729 N 7TH St
Newark, NJ 07107-2728
Phone
(973) 914-6614
NPI assigned
Nov 8, 2021
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 26NJ01198000 NJ Primary

Addresses

Primary practice location

729 N 7TH St
Newark, NJ 07107-2728

Mailing address

729 N 7TH St
Newark, NJ 07107-2728
Phone (973) 914-6614

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
I20220217002760 NJ Practitioner - Nurse Practitioner 4880088780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shah Anuj MD PCGroup PAC ID 5395006902, 29 clinicians

Practice addresses (Care Compare)

293 Passaic St
Passaic, NJ 07055-5803
Phone (973) 916-0002

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01198000NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shah Anuj MD PC CurrentSince Jan 1, 2022 Accepting new patients

Locations

591 Franklin Ave
Nutley, NJ 07110
Phone (973) 661-1100

293 Passaic St
Passaic, NJ 07055
Phone (732) 255-4958

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.

Hospital & facility affiliations 1

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1497410195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 N 7TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071072728",
            "telephone_number": "973-914-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 N 7TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071072728",
            "telephone_number": "973-914-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JENILL",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01198000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.