Individual provider Active NPI

Cristina Whelan

  • Family Nurse Practitioner
  • Nutley, NJ
National Provider Identifier
1841524915
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01100400 Issued in NJ
Practice address
349 Passaic Ave
Nutley, NJ 07110-2738
Phone
(973) 667-8889
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 33 335809 NY
Family Nurse Practitioner 363LF0000X 26NJ01100400 NJ Primary

Addresses

Primary practice location

349 Passaic Ave
Nutley, NJ 07110-2738

Mailing address

349 Passaic Ave
Nutley, NJ 07110-2738
Phone (973) 667-8889

Other practice location 1

1 Edgewater St
6th Floor
Staten Island, NY 10305-4907
Phone (718) 226-1047

Other identifiers 2

IdentifierTypeStateIssuer
03569124MedicaidNY
0988197MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130822000016 NY Practitioner - Nurse Practitioner 1153564133 Reassigns benefits to 1 organization
I20240501001632 NJ Practitioner - Nurse Practitioner 1153564133 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians
Avenir Ventures LLCGroup PAC ID 1153593017, 33 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

21 Main St
Suite 253
Hackensack, NJ 07601-7086
Phone (877) 202-2869

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8000

Hospital & facility affiliations

  • Valley Hospital Hospital, Paramus, NJ, CCN 310012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01100400NJMDFamily Nurse Practitioner
33 335809NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince Mar 2, 2019 Accepting new patients
Avenir Ventures LLC CurrentSince Oct 1, 2024 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Apr 8, 2024 Accepting new patients
Avenir Ventures, L.L.C. CurrentSince Sep 23, 2024 Accepting new patients
Valley Physician Services PC CurrentSince Jan 19, 2026 Accepting new patients
Sun River Health Inc Current Accepting new patients

Locations

3854 American Way
Ste A
Baton Rouge, LA 70816
Phone (225) 299-3253

21 Main St
Ste 253
Hackensack, NJ 07601
Phone (201) 342-7766

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

349 Passaic Ave
Nutley, NJ 07110
Phone (973) 214-5988

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

57 Bay St
Staten Island, NY 10301
Phone (718) 226-3200

Organizations & group practices 6

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 1

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": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1841524915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 PASSAIC AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102738",
            "telephone_number": "973-667-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 PASSAIC AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102738",
            "telephone_number": "973-667-8889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Edgewater St",
            "address_2": "6th Floor",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103054907",
            "country_code": "US",
            "telephone_number": "718-226-1047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHELAN",
        "first_name": "CRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33 335809",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01100400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03569124",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0988197",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

Verify at the official NPI Registry.