Individual provider Active NPI

Jenifer Brilla, CRNP

  • Nurse Practitioner
  • Dunmore, PA
National Provider Identifier
1902832082
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP 008066 Issued in PA
Practice address
502 N Blakely St
Dunmore, PA 18512-1943
Phone
(570) 342-8434
Fax
(570) 342-7446
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP 008066 PA Primary

Addresses

Primary practice location

502 N Blakely St
Dunmore, PA 18512-1943

Mailing address

1251 Wyoming Ave
Exeter, PA 18643-1434
Phone (570) 342-8434

Other practice location 1

470 Wyoming Ave
Kingston, PA 18704-3603
Phone (570) 342-8434

Other practice location 2

121 Moosic Rd
Old Forge, PA 18518-2082
Phone (570) 342-8434

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
I20040115000470 PA Practitioner - Nurse Practitioner 4183525975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tiffany Griffiths Psy D and Associates IncGroup PAC ID 5496907776, 14 clinicians

Practice addresses (Care Compare)

121 Moosic Rd
Old Forge, PA 18518-2082
Phone (570) 342-8434

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP 008066PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health Services, LLC CurrentSince Jun 4, 2023 Accepting new patients
Tiffany Griffiths Psy D & Associates Inc CurrentSince Jan 1, 2015 Accepting new patients

Locations

502 N Blakely St
Dunmore, PA 18512
Phone (570) 342-8434

1251 Wyoming Ave
Exeter, PA 18643
Phone (570) 307-9054

470 Wyoming Ave
Kingston, PA 18704
Phone (570) 288-4551

121 Moosic Rd
Old Forge, PA 18518
Phone (570) 342-8434

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1902832082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 WYOMING AVE",
            "city": "EXETER",
            "state": "PA",
            "postal_code": "186431434",
            "telephone_number": "570-342-8434",
            "fax_number": "570-299-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N BLAKELY ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185121943",
            "telephone_number": "570-342-8434",
            "fax_number": "570-342-7446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "470 Wyoming Ave",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "PA",
            "postal_code": "187043603",
            "country_code": "US",
            "telephone_number": "570-342-8434",
            "fax_number": "570-288-1084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "121 Moosic Rd",
            "address_purpose": "LOCATION",
            "city": "Old Forge",
            "state": "PA",
            "postal_code": "185182082",
            "country_code": "US",
            "telephone_number": "570-342-8434",
            "fax_number": "570-299-2521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRILLA",
        "first_name": "JENIFER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP 008066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

Verify at the official NPI Registry.