Individual provider Active NPI

Jenna Rose Constantino, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1093269300
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019884 Issued in NY
Practice address
177 Fort Washington Ave
Division of Cardiothoracic Surgery, Nyph, MHB7-435
New York, NY 10032-3733
Phone
(212) 305-2862
NPI assigned
Aug 4, 2016
Last updated
Aug 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019884 NY Primary

Addresses

Primary practice location

177 Fort Washington Ave
Division of Cardiothoracic Surgery, Nyph, MHB7-435
New York, NY 10032-3733

Mailing address

177 Fort Washington Ave
Division of Cardiothoracic Surgery, Nyph, MHB7-435
New York, NY 10032-3733

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
I20260605002041 NY Practitioner - Physician Assistant 0042781486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

41 E Post Rd
White Plains, NY 10601-4607

PO Box
Suite 2000
East Syracuse, NY 13057

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019884NYMDStudent in an Organized Health Care Education/Training Program

Networks

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

Interoperability endpoints

  • Direct secure messaging: jec2059@direct.nyp.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1093269300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "address_2": "DIVISION OF CARDIOTHORACIC SURGERY, NYPH, MHB7-435",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "address_2": "DIVISION OF CARDIOTHORACIC SURGERY, NYPH, MHB7-435",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "212-305-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTINO",
        "first_name": "JENNA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.