Individual provider Active NPI

Jacob Palathinkal, N.P

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Oaks, NY
National Provider Identifier
1023313459
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F40134 Issued in NY
Practice address
7559 263Rd St
Glen Oaks, NY 11004-1150
Phone
(718) 470-7000
NPI assigned
Jan 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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 F40134 NY Primary

Addresses

Primary practice location

7559 263Rd St
Glen Oaks, NY 11004-1150

Mailing address

7559 263Rd St
Glen Oaks, NY 11004-1150

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
I20110706000367 NY Practitioner - Nurse Practitioner 6901084318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F40134NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Nov 15, 2013 Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 15, 2013 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

7559 263rd St
Rm 132
Glen Oaks, NY 11004
Phone (718) 470-8023

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: jacobpalathinkal@nslijmedgr.allscriptsdirect.net

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": "1295049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1023313459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7559 263RD ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7559 263RD ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041150",
            "telephone_number": "718-470-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALATHINKAL",
        "first_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-15",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F40134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

Verify at the official NPI Registry.