Individual provider Active NPI

Renee Elizabeth Kravchak

  • Registered Nurse
  • Philadelphia, PA
National Provider Identifier
1730057779
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN709540 Issued in PA
Practice address
325 Chestnut St Ste 800
Philadelphia, PA 19106-2608
Phone
(973) 241-1356
NPI assigned
Oct 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP030629 PA
Registered Nurse 163W00000X RN709540 PA Primary

Addresses

Primary practice location

325 Chestnut St Ste 800
Philadelphia, PA 19106-2608

Mailing address

1126 Bryan St
Drexel Hill, PA 19026-1812
Phone (215) 385-6444

Other practice location 1

1126 Bryan St
Drexel Hill, PA 19026-1812
Phone (215) 385-6444 ext. 56444

Other practice location 2

101 Greenwood Ave Ste 140
Jenkintown, PA 19046-2649
Phone (973) 241-1356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251219000716 PA Practitioner - Nurse Practitioner 4486149218 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ennoble HC NJ PCGroup PAC ID 0345638185, 129 clinicians

Practice addresses (Care Compare)

325 Chestnut St
Suite 800
Philadelphia, PA 19106-2608
Phone (973) 241-1356

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN709540PAMDRegistered Nurse
SP030629PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ennoble HC NJ II PC CurrentSince Oct 20, 2025 Accepting new patients
Ennoble HC NJ PC CurrentSince Dec 8, 2025 Accepting new patients
Ennoble HC NJ III PC CurrentSince Oct 20, 2025 Accepting new patients

Locations

2 University Plz
Ste 204
Hackensack, NJ 07601
Phone (201) 564-0142

101 Greenwood Ave
Ste 140
Jenkintown, PA 19046
Phone (973) 241-1356

325 Chestnut St
Ste 800
Philadelphia, PA 19106
Phone 9732411356 ext. 11356

Organizations & group practices 3

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": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1730057779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 BRYAN ST",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190261812",
            "telephone_number": "215-385-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CHESTNUT ST STE 800",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191062608",
            "telephone_number": "973-241-1356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1126 Bryan St",
            "address_purpose": "LOCATION",
            "city": "Drexel Hill",
            "state": "PA",
            "postal_code": "190261812",
            "country_code": "US",
            "telephone_number": "215-385-6444 x56444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Greenwood Ave Ste 140",
            "address_purpose": "LOCATION",
            "city": "Jenkintown",
            "state": "PA",
            "postal_code": "190462649",
            "country_code": "US",
            "telephone_number": "973-241-1356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAVCHAK",
        "first_name": "RENEE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP030629",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN709540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.