Individual provider Active NPI

Jenna Delucia, APRN

  • Women's Health Nurse Practitioner
  • Norwalk, CT
National Provider Identifier
1790394518
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
9033 Issued in CT
Practice address
761 Main Ave Ste 106
Norwalk, CT 06851-1080
Phone
(203) 846-8885
Fax
(203) 846-6032
NPI assigned
Jul 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 164932 CT
Women's Health Nurse Practitioner 363LW0102X 9033 CT Primary

Addresses

Primary practice location

761 Main Ave Ste 106
Norwalk, CT 06851-1080

Mailing address

761 Main Ave Ste 106
Norwalk, CT 06851-1080
Phone (203) 846-8885

Other names 1

  • Jenna Hernandez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20201204000783 CT Practitioner - Nurse Practitioner 2668883190 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

148 E Ave
Norwalk, CT 06851-5721
Phone (203) 846-8885

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
164932CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Hospital Association CurrentSince Dec 15, 2020 Accepting new patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Nov 16, 2020 Accepting new patients
Norwalk Hospital Association CurrentSince Dec 15, 2020 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

148 East Ave
Norwalk, CT 06851
Phone (203) 838-4886

761 Main Ave
Norwalk, CT 06851
Phone (203) 845-2160

761 Main Ave
Ste 106
Norwalk, CT 06851
Phone (203) 838-0442

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1790394518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 106",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-846-8885",
            "fax_number": "203-846-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 106",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-846-8885",
            "fax_number": "203-846-6032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCIA",
        "first_name": "JENNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "164932",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "9033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "HERNANDEZ",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.