Jacqueline Rose Thaw

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

034153 Issued in NY

Practice address

1000 Montauk Hwy
West Islip, NY 11795-4927

Phone

(631) 376-3000

NPI assigned

Aug 5, 2025

Sex

Unspecified or another gender identity

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Joseph HospitalGroup PAC ID 1254222938, 101 clinicians

Progressive Emergency Physicians PLLCGroup PAC ID 8820225956, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

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

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.

• Progressive Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Uniondale, NY
  • NPI 1588098172
  Medicare reassignment Care Compare group NPD
• St. Joseph Hospital

  • Specialist
  • Bethpage, NY
  • NPI 1881799153
  Medicare reassignment Care Compare group
• Good Samaritan Hospital Medical Center

  • Physician Assistant
  • West Islip, NY
  • NPI 1518901180
  Medicare reassignment
• Samaritan Emergency Medical Services, PC

  • Emergency Medicine Physician
  • West Islip, NY
  • NPI 1104978014
  Medicare reassignment
• Good Samaritan Hospital Medical

  • Critical Care Medicine (Internal Medicine) Physician
  • West Islip, NY
  • NPI 1548501620
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wsnchs North, Inc.

  • General Acute Care Hospital
  • Bethpage, NY
  • NPI 1013998426
  Care Compare affiliation

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1063396661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAW",
        "first_name": "JACQUELINE",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis K Teitelbaum, M.D., L. F.A.P.A.
• Lorraine Telesmanic
• Melissa Anne Terpko, M.S. CCC-SLP P.C
• Jane Marie Testa
• Ellen Viola Thalhamer III, M.S.ED., B.,C.S.E
• The Stop & Shop Supermarket Company LLC
• Renee Meyatta Thomas, MD
• Janet Thompson, R.N.
• Magdalena Tibett
• Howard M Tichler, DDS

• Physician Assistant in West Islip, NY
• Providers in West Islip, 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 Aug 5, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.