Individual provider Active NPI

Jenelle L. Romig, PA-C

  • Physician Assistant
  • Hazleton, PA
National Provider Identifier
1669873741
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062050 Issued in PA
Practice address
700 E Broad St
Hazleton, PA 18201-6835
Phone
(570) 501-4193
NPI assigned
Sep 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 017898 NY
Physician Assistant 363A00000X MA062050 PA Primary

Addresses

Primary practice location

700 E Broad St
Hazleton, PA 18201-6835

Mailing address

152 Lehigh Ave
Palmerton, PA 18071-1714
Phone (610) 393-6328

Other practice location 1

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160107003193 FL Practitioner - Physician Assistant 3678898939 Reassigns benefits to 3 organizations
I20230622000096 PA Practitioner - Physician Assistant 3678898939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2023 Accepting new patients
Tampa General Hospital Current Accepting new patients
Quality Drive Emergency Physicians LLC Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

700 E Broad St
Hazleton, PA 18201
Phone (570) 501-4000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jromig296544@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 8

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": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1669873741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 LEHIGH AVE",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "180711714",
            "telephone_number": "610-393-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182016835",
            "telephone_number": "570-501-4193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-3125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMIG",
        "first_name": "JENELLE",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017898",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

Verify at the official NPI Registry.