Individual provider Active NPI

Jessica Rae Plotnikov, MD

  • Psychiatry Physician
  • New Square, NY
National Provider Identifier
1073141123
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
327725 Issued in NY
Practice address
728 N Main St
New Square, NY 10977-8916
Phone
(845) 345-9300
NPI assigned
Apr 1, 2020
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 327725 NY Primary

Addresses

Primary practice location

728 N Main St
New Square, NY 10977-8916

Mailing address

728 N Main St
New Square, NY 10977-8916
Phone (845) 354-9300

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827002739 NY Practitioner - Psychiatry 3476054958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Refuah Health Center IncGroup PAC ID 4880584416, 88 clinicians

Practice addresses (Care Compare)

408 Wilson Ave
New Square, NY 10977-1946
Phone (845) 354-9300

5 Twin Ave
Spring Valley, NY 10977-3950
Phone (845) 354-9300

728 N Main St
Spring Valley, NY 10977-8614

728 N Main St
New Square, NY 10977-8916
Phone (845) 354-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
327725NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Refuah Health Center, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Refuah Health Center Inc Current Accepting new patients
Refuah Health Center, Inc. CurrentSince Aug 1, 2025 Accepting new patients

Locations

728 N Main St
New Square, NY 10977
Phone (845) 354-9301

5 Twin Ave
Spring Valley, NY 10977
Phone 84535493001249

Networks

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1073141123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 N MAIN ST",
            "city": "NEW SQUARE",
            "state": "NY",
            "postal_code": "109778916",
            "telephone_number": "845-354-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N MAIN ST",
            "city": "NEW SQUARE",
            "state": "NY",
            "postal_code": "109778916",
            "telephone_number": "845-345-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOTNIKOV",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "327725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Square, NY

Sources for this page

Verify at the official NPI Registry.