LAURA LYNN BRENNECKE CRNP
NPI 1174995310
Nurse Practitioner - Pediatrics in Philadelphia, PA
About Laura Lynn Brennecke Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAURA LYNN BRENNECKE CRNP (NPI 1174995310) is an individual pediatrics provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP015549) and active in the NPI registry since October 2015. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Laura Lynn Brennecke Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Laura Brennecke reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Philadelphia, PA 19104
- Reassigned Medicare billing, Pennsylvania enrollment
- 1,225 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Laura Brennecke's NPI number?
The NPI number for Laura Brennecke is 1174995310. It was assigned to this individual provider in the NPPES registry on October 27, 2015.
Where is Laura Brennecke located?
Laura Brennecke practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (215) 590-3630.
What is Laura Brennecke's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Laura Brennecke enrolled in Medicare?
Yes. Laura Brennecke is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Laura Brennecke's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Laura Brennecke reassigns Medicare benefits to Childrens Health Care Associates, Inc (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Laura Brennecke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Laura Brennecke was last updated on November 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Laura Lynn Brennecke, CRNP · NPI 1174995310
Pediatrics physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since October 27, 2015.
## Identity
- **NPI:** 1174995310 (Entity type: Individual)
- **Enumerated:** October 27, 2015
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** SP015549 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 3401 CIVIC CENTER BLVD, Philadelphia, PA 19104-4399
- **Phone:** (215) 590-3630
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Childrens Health Care Associates, Inc (NPI 1033204086, Philadelphia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 14, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1174995310) · Data from the CMS NPPES public registry.