Individual provider Active NPI

Anna Valeria De la Pena Duenas, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Jersey City, NJ
National Provider Identifier
1558065680
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
355 Grand Street
Jersey City, NJ 07302
Phone
(201) 915-2431
Fax
(201) 915-2219
NPI assigned
Mar 30, 2023
Reactivated
Dec 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

355 Grand Street
Jersey City, NJ 07302

Mailing address

400 Claremont Avenue
Unit 5108
Jersey City, NJ 07304
Phone (786) 557-9403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1558065680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CLAREMONT AVENUE",
            "address_2": "UNIT 5108",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07304",
            "telephone_number": "786-557-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GRAND STREET",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07302",
            "telephone_number": "201-915-2431",
            "fax_number": "201-915-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA PENA DUENAS",
        "first_name": "ANNA VALERIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-12-23",
        "certification_date": "2023-03-30",
        "deactivation_date": "2023-11-01",
        "reactivation_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.