Individual provider Active NPI

Jeneba Katie Sawaneh, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Aldan, PA
National Provider Identifier
1902636822
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP029782 Issued in PA
Practice address
17 S Oak Ave Apt a
Aldan, PA 19018-3724
Phone
(267) 392-9647
NPI assigned
Aug 5, 2024
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP029782 PA Primary

Addresses

Primary practice location

17 S Oak Ave Apt a
Aldan, PA 19018-3724

Mailing address

17 S Oak Ave Apt a
Aldan, PA 19018-3724
Phone (267) 392-9647

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
I20241011001180 PA Practitioner - Nurse Practitioner 8224560545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Supportive Care of Pennsylvania LLCGroup PAC ID 0143521211, 91 clinicians

Practice addresses (Care Compare)

2109 Red Lion Rd
Philadelphia, PA 19115-1711
Phone (718) 298-4375

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP029782PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of Pennsylvania LLC CurrentSince Sep 15, 2024 Accepting new patients
Streams of Hope Behavioral Health & Wellness Services LLC Psychiatric/Mental Health Current Accepting new patients
Muhammad Nadeem Shamsi, PC. CurrentSince Feb 24, 2025 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

1412 Lansdowne Ave
Darby, PA 19023
Phone (610) 461-6510

2109 Red Lion Rd
Philadelphia, PA 19115
Phone (215) 213-7000

1000 Germantown Pike
Ste H4
Plymouth Mtng, PA 19462
Phone (610) 275-0345

1130 W Chester Pike
West Chester, PA 19382
Phone (215) 815-7500

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, 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": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1902636822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 S OAK AVE APT A",
            "city": "ALDAN",
            "state": "PA",
            "postal_code": "190183724",
            "telephone_number": "267-392-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S OAK AVE APT A",
            "city": "ALDAN",
            "state": "PA",
            "postal_code": "190183724",
            "telephone_number": "267-392-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWANEH",
        "first_name": "JENEBA",
        "middle_name": "KATIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP029782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aldan, PA

Sources for this page

Verify at the official NPI Registry.