Jacqueline Pelka, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN.CNP.18049 Issued in OH

Practice address

1250 Linda St
Suite 103
Rocky River, OH 44116-1853

Phone

(440) 250-3560

Fax

(330) 670-8569

NPI assigned

Jan 20, 2016

Last updated

Sep 16, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: jpelka20913@carelonhealth.direct-ci.com

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.

• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  OH

  Medicare reassignment
• Qofl Services LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1942554837
  NPD (past)

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1528425675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 LINDA ST",
            "address_2": "SUITE 103",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161853",
            "telephone_number": "440-250-3560",
            "fax_number": "330-670-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 LINDA ST",
            "address_2": "SUITE 103",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161853",
            "telephone_number": "440-250-3560",
            "fax_number": "330-670-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELKA",
        "first_name": "JACQUELINE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.18049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Jean Parks, PHARMD, RPH
• Kelly Parsons, FNP-C
• Kishor Patel I, MD
• Scott E Patterson, M.D.
• Marni Peate
• Marissa Pelsozy, LSW
• Ashley S Penman, LISW
• Lisa Pepera, L.P.C.C.-S
• Aubrey Phelps, RD CLC
• Philip R Belzunce PHD Inc

• Nurse Practitioner in Rocky River, OH
• Providers in Rocky River, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.