Individual provider Active NPI

Jill Rice, APRN PMHNP AND FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hamburg, NY
National Provider Identifier
1093823361
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F404957 Issued in NY
Practice address
3750 Heatherwood Dr Apt L5
Hamburg, NY 14075-2272
Phone
(694) 693-3044
NPI assigned
Aug 28, 2006
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F351891 NY
Family Nurse Practitioner 363LF0000X 676803 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F404957 NY Primary

Addresses

Primary practice location

3750 Heatherwood Dr Apt L5
Hamburg, NY 14075-2272

Mailing address

PO Box 68049
Newark, NJ 07101-8085
Phone (469) 693-3044

Other identifiers 3

IdentifierTypeStateIssuer
676803OtherTXLICENSE
F351891OtherNYNY FNP
F404957OtherNYNY PMHNP

Other names 1

  • Jill Johnson Former name

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
I20240909004610 NY Practitioner - Nurse Practitioner 1850428822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

300 Cadman PLZ W
Brooklyn, NY 11201-3211
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F351891NYMDFamily Nurse Practitioner
F404957NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Psychiatric/Mental Health CurrentSince Aug 30, 2024 Accepting new patients
Knapp Street Psychiatry, PC Psychiatric/Mental Health CurrentSince Aug 30, 2024 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

100 Park Ave
Fl 16
New York, NY 10017
Phone (212) 433-2384

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1093823361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68049",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071018085",
            "telephone_number": "469-693-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 HEATHERWOOD DR APT L5",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140752272",
            "telephone_number": "694-693-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "JILL",
        "credential": "APRN PMHNP AND FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F351891",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "676803",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "676803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY FNP",
            "identifier": "F351891",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY PMHNP",
            "identifier": "F404957",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "JOHNSON",
            "credential": "APRN PMHNP FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.