Jeanine Michelle Carnival, MS, RN, AGNP-C, CCRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F308885 Issued in NY

Practice address

101 Nicholls Road Stony Brook Hospita
Stony Brook, NY 11794-0001

Phone

(631) 444-1665

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: jcarnival675205@nyumc.direct-ci.com

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1033764006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICHOLLS ROAD STONY BROOK HOSPITA",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICHOLLS ROAD STONY BROOK HOSPITA",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNIVAL",
        "first_name": "JEANINE",
        "middle_name": "MICHELLE",
        "credential": "MS, RN, AGNP-C, CCRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Carleo, M.D.
• Gabrielle Carlson, M.D.
• Vanessa Elizabeth Carmona Tamayo, PA-C
• Diana V Carney, N.P.
• Alexandra M Carnival
• Jorge Humberto Carpintero, NP
• Daniel David Carris, DO
• Marina Carro
• Mallory Paige Carson, DO
• Jason Alexander Carter

• Adult Health Nurse Practitioner in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.