Active NPI
Jaclyn McKinstry, M.D.
- Pediatric Critical Care Medicine Physician
- New York, NY
National Provider Identifier
1104052778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 277037
- Practice address
- 403 E 34TH St
New York, NY 10016-4972 - Phone
- (212) 263-8475
- NPI assigned
- Jun 9, 2009
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 241114 | MA | |
| Pediatric Cardiology Physician | 2080P0202X | 277037 | NY | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 277037 | NY | Primary |
Addresses
Primary practice location
403 E 34TH St
New York, NY 10016-4972
Mailing address
1575 Tremont St
Apt #209
Roxbury Crossing, MA 02120-1677
Phone (856) 952-9206
Other practice location 1
300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmckinstry268743@nyumc.direct-ci.com |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 241114 | MA | MD | Pediatrics Physician |
| 277037 | NY | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Pediatrics | Current | Accepting new patients |
| NYU Langone Hospitals | Past | Accepting new patients |
Locations
403 E 34th St
New York, NY 10016
Phone (212) 263-8134
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- jmckinstry268743@nyumc.direct-ci.com
- jmckinstry679318@nychhc.direct-ci.com
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY, Pediatrics
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660521600000",
"number": "1104052778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 TREMONT ST",
"address_2": "APT #209",
"city": "ROXBURY CROSSING",
"state": "MA",
"postal_code": "021201677",
"telephone_number": "856-952-9206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 E 34TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100164972",
"telephone_number": "212-263-8475"
}
],
"practiceLocations": [
{
"address_1": "300 Longwood Ave",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021155724",
"country_code": "US",
"telephone_number": "617-355-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKINSTRY",
"first_name": "JACLYN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-09",
"last_updated": "2022-08-15",
"certification_date": "2022-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "241114",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "NY",
"license": "277037",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "NY",
"license": "277037",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmckinstry268743@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "403 E 34th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100164972",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.