Individual provider Active NPI

Renae N Defreitas, CRNP

  • Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1649642612
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015541 Issued in PA
Practice address
1005 Brookside Rd
Allentown, PA 18106-9023
Phone
(610) 351-0419
NPI assigned
Oct 29, 2015
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP015541 PA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP025849 PA

Addresses

Primary practice location

1005 Brookside Rd
Allentown, PA 18106-9023

Mailing address

3614 Country Club Rd
Allentown, PA 18103-6983
Phone (484) 547-8060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015541PAMDNurse Practitioner
SP025849PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital - Anderson Campus CurrentSince Jun 1, 2018 Accepting new patients
St. Luke's Quakertown Hospital CurrentSince Jun 1, 2018 Accepting new patients
The Carbon-Schuylkill Community Hospital, Inc. Current Accepting new patients
St. Luke's Quakertown Hospital Current Accepting new patients
St. Luke's Hospital CurrentSince Jun 1, 2018 Accepting new patients
St. Luke's Quakertown Hospital CurrentSince Jun 1, 2018 Accepting new patients
St Luke's Hospital CurrentSince Jun 1, 2018 Accepting new patients
St. Luke's Hosptial Current Accepting new patients
The Carbon Schuylkill Community Hospital, Inc. CurrentSince Jun 1, 2018 Accepting new patients
St. Luke's Hospital Monroe Campus CurrentSince Jun 1, 2018 Accepting new patients
St. Luke's Hospital Monroe Campus CurrentSince Jun 1, 2018 Accepting new patients
The Carbon Schuylkill Community Hospital, Inc. CurrentSince Jun 1, 2018 Accepting new patients
St. Luke's Hospital Current Accepting new patients
Valley Pain Specialists PC CurrentSince May 23, 2016 Accepting new patients
Meribah Clinic LLC Psychiatric/Mental Health Past Accepting new patients

Locations

4250 Fritch Dr
Bethlehem, PA 18020
Phone (610) 954-9040

111 Route 715
Brodheadsvlle, PA 18322
Phone (272) 212-0420

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1104 North St
Jim Thorpe, PA 18229
Phone (570) 325-2400

2402 MacArthur Rd
Whitehall, PA 18052
Phone (484) 426-2026

487 E Moorestown Rd
Wind Gap, PA 18091
Phone (484) 526-7850

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1649642612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 COUNTRY CLUB RD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036983",
            "telephone_number": "484-547-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROOKSIDE RD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069023",
            "telephone_number": "610-351-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFREITAS",
        "first_name": "RENAE",
        "middle_name": "N",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2022-10-05",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015541",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.