Active NPI
Marc Allen Valencia, APN
- Nurse Practitioner
- Newark, NJ
National Provider Identifier
1861245680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 26NJ15011000
- Practice address
- 201 Lyons Ave
Newark, NJ 07112-2027 - Phone
- (973) 926-7000
- NPI assigned
- Apr 10, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 26NJ15011000 | NJ | |
| Nurse Practitioner | 363L00000X | 26NJ15011000 | NJ | Primary |
Addresses
Primary practice location
201 Lyons Ave
Newark, NJ 07112-2027
Mailing address
1201 Summit Ave Apt 407
Jersey City, NJ 07307-3174
Phone (551) 655-4647
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ15011000 | NJ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group PC | Current | Accepting new patients | |
| Barnabas Health Medical Group PC | Current | Accepting new patients |
Locations
475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000
94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400
201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455
201 Lyons Ave
#L4
Newark, NJ 07112
Phone (973) 926-7154
Organizations & group practices 2
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.
-
- Specialist
- Elizabeth, NJ
- NPI 1841557246
-
- Durable Medical Equipment & Medical Supplies
- Hackensack, NJ
- NPI 1316772668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1861245680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 SUMMIT AVE APT 407",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073073174",
"telephone_number": "551-655-4647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 LYONS AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071122027",
"telephone_number": "973-926-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENCIA",
"first_name": "MARC",
"middle_name": "ALLEN",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-10",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LC0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Critical Care Medicine",
"state": "NJ",
"license": "26NJ15011000",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NJ",
"license": "26NJ15011000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.