Individual provider Active NPI

Jeanne Catherine Hickey, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1073890455
Registry record updated Nov 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336336 Issued in NY
Practice address
1521 Jarret PL
Bronx, NY 10461-2606
Phone
(718) 862-8840
NPI assigned
Nov 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 336336 NY Primary

Addresses

Primary practice location

1521 Jarret PL
Bronx, NY 10461-2606

Mailing address

161 Westchester Ave
Thornwood, NY 10594-1218
Phone (914) 769-7210

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000603 NY Practitioner - Nurse Practitioner 7012189665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (914) 378-6148

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
336336NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 6, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Jan 6, 2016 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1521 Jarret Pl
Bronx, NY 10461
Phone (718) 239-8733

Networks

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

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1321142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321142400000",
    "number": "1073890455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WESTCHESTER AVE",
            "city": "THORNWOOD",
            "state": "NY",
            "postal_code": "105941218",
            "telephone_number": "914-769-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 JARRET PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612606",
            "telephone_number": "718-862-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "JEANNE",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-13",
        "last_updated": "2011-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.