Individual provider Active NPI

Jessica Blue, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1033193768
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
F420760 Issued in NY
Practice address
26 Bleecker St
New York, NY 10012-2413
Phone
(212) 274-7250
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X F420760 NY Primary

Addresses

Primary practice location

26 Bleecker St
New York, NY 10012-2413

Mailing address

26 Bleecker St
New York, NY 10012-2413
Phone (212) 274-7250

Other identifiers 1

IdentifierTypeStateIssuer
02766681MedicaidNY

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
I20200527000143 NY Practitioner - Nurse Practitioner 9032530282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Perelman School of Med at the University of Pennsylvania, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Planned Parenthood of Greater New York IncGroup PAC ID 7810293297, 34 clinicians

Practice addresses (Care Compare)

44 Court St
Brooklyn, NY 11201-4405
Phone (718) 852-6879

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F420760NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Greater New York Inc CurrentSince Jan 19, 2020 Accepting new patients
Planned Parenthood of the Southern Finger Lakes Inc. Past Accepting new patients

Locations

44 Court St
Fl 6
Brooklyn, NY 11201
Phone (718) 852-6879

540 Fulton Ave
Hempstead, NY 11550
Phone (516) 750-2600

2141 45th Rd
Long Island City, NY 11101
Phone (212) 965-7000

35 Carmans Rd
Massapequa, NY 11758

26 Bleecker St
Prince, NY 10012
Phone (212) 274-7226

543 Bay Rd
Queensbury, NY 12804
Phone (518) 761-2663

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1033193768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 BLEECKER ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122413",
            "telephone_number": "212-274-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BLEECKER ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122413",
            "telephone_number": "212-274-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F420760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02766681",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.