Active NPI
Jaclyn Sara Dimattei, NP
- Adult Health Nurse Practitioner
- Smithtown, NY
National Provider Identifier
1093238222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 308286
- Practice address
- 75 Landing Meadow Rd
Smithtown, NY 11787-1124 - Phone
- (631) 360-4700
- NPI assigned
- Jul 19, 2017
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 308286 | NY | Primary |
Addresses
Primary practice location
75 Landing Meadow Rd
Smithtown, NY 11787-1124
Mailing address
269 Radio Ave
Miller Place, NY 11764-3528
Other practice location 1
33 Terryville Rd
Port Jefferson Station, NY 11776-1331
Phone (631) 439-4300
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- State University of New York at Stony Brook, School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
75 Landing Meadow Rd
Smithtown, NY 11787-1124
Phone (631) 650-2510
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long Island Select Healthcare, Inc. | Current | Accepting new patients | |
| Long Island Select Healthcare, Inc. | Current | Accepting new patients |
Locations
159 Carleton Ave
Central Islip, NY 11722
Phone (631) 439-4300
120 Plant Ave
Hauppauge, NY 11788
Phone (631) 273-1300
33 Terryville Rd
Port Jefferson Station, NY 11776
Phone (631) 474-5100
883 E Main St
Riverhead, NY 11901
Phone (631) 284-5500
75 Landing Meadow Rd
Smithtown, NY 11787
Phone (631) 360-4700
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- jaclyn.dimattei.1@24989.direct.athenahealth.com
- https://fhir4.healow.com/fhir/r4/CCJFAD
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.
-
- Federally Qualified Health Center (FQHC)
- Central Islip, NY
- NPI 1043663107
-
- Developmental Disabilities Clinic/Center
- Riverhead, NY
- NPI 1265987150
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
-
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1164481529
-
- Home Health Agency
- Medford, NY
- NPI 1699715961
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1093238222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "269 RADIO AVE",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117643528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 LANDING MEADOW RD",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117871124",
"telephone_number": "631-360-4700"
}
],
"practiceLocations": [
{
"address_1": "33 Terryville Rd",
"address_purpose": "LOCATION",
"city": "Port Jefferson Station",
"state": "NY",
"postal_code": "117761331",
"country_code": "US",
"telephone_number": "631-439-4300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIMATTEI",
"first_name": "JACLYN",
"middle_name": "SARA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "308286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.