MARC ALLEN VALENCIA APN
NPI 1861245680
Nurse Practitioner in Newark, NJ

Q: What is Marc Valencia's NPI number?

The NPI number for Marc Valencia is 1861245680. It was assigned to this individual provider in the NPPES registry on April 10, 2024.

Q: What is Marc Valencia's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Marc Valencia was last updated on April 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 10, 2024PECOS Enrolled

201 LYONS AVE, NEWARK, NJ 07112(973) 926-7000 Get Directions Write a Review

NPPES record last updated: April 10, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Marc Allen Valencia Apn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARC ALLEN VALENCIA APN (NPI 1861245680) is an individual nurse practitioner in Newark, New Jersey, licensed in New Jersey (26NJ15011000) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861245680

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameMARC ALLEN VALENCIACredential: APN

Location Address201 LYONS AVENewark, NJ 07112-2027

Mailing Address1201 Summit Ave Apt 407Jersey City, NJ 07307-3174 · (551) 655-4647

Phone(973) 926-7000

Sole ProprietorNo

Enumeration DateApril 10, 2024

NPPES CertifiedApril 10, 2024

✔ NPI 1861245680 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NJ · 26NJ15011000

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · Critical Care MedicineTaxonomy 363LC0200X · License 26NJ15011000 (NJ)

201 LYONS AVE, Newark, NJ 07112

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marc Allen Valencia Apn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Marc Valencia reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Barnabas Health Medical Group PC

3.5 mi

Specialist

225 WILLIAMSON ST
Elizabeth, NJ 07202

Reassigned Medicare billing, New Jersey enrollment
1,894 clinicians in this Medicare group

NPI 1841557246 (888) 724-7123

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 07112 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. KEITH MICHAEL SPELLMAN M.D.

Radiology (Diagnostic Radiology)

201 LYONS AVE
NEWARK, NJ 07112

Essex County (973) 926-7960

DR. LARISSA SOPHIA DUDLEY M.D.

Emergency Medicine

201 LYONS AVE, SUITE D11
NEWARK, NJ 07112

Essex County (973) 926-6671

WAQAS BARI MD

Student in an Organized Health Care Education/Training Program

201 LYONS AVE
NEWARK, NJ 07112

Essex County (800) 843-2384

ERIKA YESENIA PINEDA MD

Pediatrics (Pediatric Critical Care Medicine)

201 LYONS AVE
NEWARK, NJ 07112

Essex County (973) 926-7000

CASEY YEONJOO CHO APN

Nurse Practitioner (Acute Care)

201 LYONS AVE
NEWARK, NJ 07112

Essex County (973) 926-6938

KARLINA NGUYEN PA-C

Physician Assistant

201 LYONS AVE
NEWARK, NJ 07112

Essex County (973) 926-7000

BRIAN CAO MD

Anesthesiology (Pediatric Anesthesiology)

201 LYONS AVE
NEWARK, NJ 07112

Essex County (973) 926-7000

DR. ALEXIS LORDI MD

Student in an Organized Health Care Education/Training Program

201 LYONS AVE
NEWARK, NJ 07112

Essex County (973) 900-4855

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 Marc Valencia's NPI number?

The NPI number for Marc Valencia is 1861245680. It was assigned to this individual provider in the NPPES registry on April 10, 2024.

Where is Marc Valencia located?

Marc Valencia practices at 201 Lyons Ave, Newark, NJ 07112. The listed phone number is (973) 926-7000.

What is Marc Valencia's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Marc Valencia enrolled in Medicare?

Yes. Marc Valencia is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Marc Valencia's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marc Valencia reassigns Medicare benefits to Barnabas Health Medical Group PC (Elizabeth, NJ). 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 Marc Valencia's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marc Valencia accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Marc Valencia as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marc Valencia was last updated on April 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.