Individual provider Active NPI

Jennifer Dewolf, NP

  • Family Nurse Practitioner
  • Rensselaer, NY
National Provider Identifier
1952754632
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
340692 Issued in NY
Practice address
2 Empire Dr Ste 100
Capital Region Family Health
Rensselaer, NY 12144-5730
Phone
(518) 286-4899
NPI assigned
Jul 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 340692 NY Primary

Addresses

Primary practice location

2 Empire Dr Ste 100
Capital Region Family Health
Rensselaer, NY 12144-5730

Mailing address

PO Box 14890
SPHP Payer Credentialing
Albany, NY 12212
Phone (518) 525-5634

Other practice location 1

2 Empire Dr Ste 101
Rensselaer, NY 12144-5730
Phone (518) 286-4960

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170118001972 NY Practitioner - Nurse Practitioner 4789966227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Empire Dr
Suite 100
Rensselaer, NY 12144-5730
Phone (518) 286-4899

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Jan 1, 2019 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Oct 24, 2022 Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

713 Troy Schenectady Rd
Ste 304
Latham, NY 12110
Phone (518) 373-4448

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

2 Empire Dr
Ste 100
Rensselaer, NY 12144
Phone (518) 286-4899

2 Empire Dr
Ste 101
Rensselaer, NY 12144
Phone (518) 286-4960

2 Empire Dr
Ste 202
Rensselaer, NY 12144
Phone (518) 286-4990

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: jdewolf789269@direct.trinity-health.org

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.

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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1952754632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "address_2": "SPHP PAYER CREDENTIALING",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12212",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EMPIRE DR STE 100",
            "address_2": "CAPITAL REGION FAMILY HEALTH",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121445730",
            "telephone_number": "518-286-4899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Empire Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "121445730",
            "country_code": "US",
            "telephone_number": "518-286-4960",
            "fax_number": "518-286-4959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWOLF",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2 Empire Dr Ste 100",
            "address_2": "Capital Region Family Health",
            "city": "Rensselaer",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121445730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

Verify at the official NPI Registry.