Individual provider Active NPI

Hannah Pienciak

  • Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1790249993
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1661157 Issued in CO
Practice address
2877 E Fountain Blvd
Colorado Springs, CO 80910-2312
Phone
(719) 454-6009
NPI assigned
Jan 22, 2019
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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 26NJ00822400 NJ
Nurse Practitioner 363L00000X 1661157 CO Primary

Addresses

Primary practice location

2877 E Fountain Blvd
Colorado Springs, CO 80910-2312

Mailing address

PO Box 746081
Atlanta, GA 30374-6081
Phone (312) 733-9730

Other practice location 1

750 Valley Brook Ave
Lyndhurst, NJ 07071-1301
Phone (201) 896-0900

Other practice location 2

50 Pompton Ave
Verona, NJ 07044-2917
Phone (973) 857-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20191029001967 CO Practitioner - Nurse Practitioner 0749512580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

2877 E Fountain Blvd
Oak Street Health Pikes Peak Park
Colorado Springs, CO 80910-2312
Phone (719) 454-6009

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918-2932
Phone (719) 454-6010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1661157COMDNurse Practitioner
26NJ00822400NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Colorado, PLLC Family Medicine Current Accepting new patients
Oak Street Health Physicians Group of Colorado, PLLC Family Medicine CurrentSince Oct 7, 2024 Accepting new patients
Oak Street Health Physicians Group of Colorado, PLLC Family Medicine CurrentSince Oct 7, 2024 Accepting new patients
Peak Vista Community Health Centers CurrentSince Oct 28, 2019 Accepting new patients
Peak Vista Community Health Centers CurrentSince Oct 28, 2019 Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

2828 International Cir
Ste 160
Colorado Springs, CO 80910
Phone (719) 344-6176

2877 E Fountain Blvd
Colorado Springs, CO 80910
Phone (719) 454-6009

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone (719) 454-6010

Interoperability endpoints

  • Direct secure messaging: hannah.pienciaknp.p1@direct.peakvista.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1790249993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746081",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746081",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2877 E FOUNTAIN BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809102312",
            "telephone_number": "719-454-6009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Valley Brook Ave",
            "address_purpose": "LOCATION",
            "city": "Lyndhurst",
            "state": "NJ",
            "postal_code": "070711301",
            "country_code": "US",
            "telephone_number": "201-896-0900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Pompton Ave",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070442917",
            "country_code": "US",
            "telephone_number": "973-857-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIENCIAK",
        "first_name": "HANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00822400",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "1661157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.