Jillian Rose McNulty, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

017781 Issued in NY

Practice address

480 South Bedford Road
Chappaqua, NY 10514

Phone

(914) 458-8863

Fax

(914) 458-8764

NPI assigned

Jul 23, 2014

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

Other identifiers 1

Other names 1

• Ms. Jillian Rose Spallina Former name

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

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmcnulty61200@northwell.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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• True North Medical Group PC

  • Oxygen Equipment & Supplies (DME)
  • Tarrytown, NY
  • NPI 1669272886
  NPD (past)

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1043628068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 SOUTH BEDFORD ROAD",
            "address_2": "PRE-SURGICAL TESTING BUILDING C",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "10514",
            "telephone_number": "914-458-8850",
            "fax_number": "914-458-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 SOUTH BEDFORD ROAD",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "10514",
            "telephone_number": "914-458-8863",
            "fax_number": "914-458-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "JILLIAN",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13781002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "SPALLINA",
            "middle_name": "ROSE",
            "prefix": "MS.",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erika N Marshall, MD
• Pat J Martin, M.D.
• Antoinette P Materasso, MS,RN
• Alison McCarville, M.S. CCC-SLP
• Julia R McLean, LCSW
• Shari Aviva Melamed-Kaplan, MD
• Corinne December Menn, D.O.
• Michael B. Singer MD PC
• Richard G Miller, MD
• Alejo Miranda, PHARMD

• Physician Assistant in Chappaqua, NY
• Providers in Chappaqua, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.