Individual provider Active NPI

Jaqueline Valencia, APN

  • Nurse Practitioner
  • Jersey City, NJ
National Provider Identifier
1639056278
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15389900 Issued in NJ
Practice address
550 Summit Ave
Jersey City, NJ 07306-2707
Phone
(201) 209-1802
Fax
(201) 209-1802
NPI assigned
Aug 18, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15389900 NJ Primary

Addresses

Primary practice location

550 Summit Ave
Jersey City, NJ 07306-2707

Mailing address

550 Summit Ave
Jersey City, NJ 07306-2707
Phone (201) 209-1802

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
I20251212001954 NJ Practitioner - Nurse Practitioner 7113411513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

281 Ave E
FL 2
Bayonne, NJ 07002-3755

57 Summit Ave
Bloomfield, NJ 07003-3844

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15389900NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yogi Medical Care Inc CurrentSince Nov 1, 2025 Accepting new patients

Locations

550 Summit Ave
Ste B1
Jersey City, NJ 07306
Phone (201) 209-1802

3665 John F Kennedy Blvd
Bsmt
Jersey City, NJ 07307
Phone (201) 963-1155

550 Summit Ave
Jersey City, NJ 07306
Phone (201) 656-5050

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1639056278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SUMMIT AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062707",
            "telephone_number": "201-209-1802",
            "fax_number": "201-209-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SUMMIT AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062707",
            "telephone_number": "201-209-1802",
            "fax_number": "201-209-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "JAQUELINE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15389900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.