Active NPI
Jenna Eivazi
- Athletic Trainer
- East Meadow, NY
National Provider Identifier
1043017130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 004927
- Practice address
- 1530 Front St
East Meadow, NY 11554-2265 - Phone
- (516) 324-7500
- NPI assigned
- Feb 26, 2025
- Last updated
- Dec 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 004927 | NY | Primary |
Addresses
Primary practice location
1530 Front St
East Meadow, NY 11554-2265
Mailing address
343 Lexington Ave
West Hempstead, NY 11552-1320
Phone (516) 477-7811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004927 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764720000000",
"number": "1043017130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "343 LEXINGTON AVE",
"city": "WEST HEMPSTEAD",
"state": "NY",
"postal_code": "115521320",
"telephone_number": "516-477-7811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 FRONT ST",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115542265",
"telephone_number": "516-324-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EIVAZI",
"first_name": "JENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-26",
"last_updated": "2025-12-03",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "004927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Meadow, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.