Individual provider Active NPI

Jennifer Rachel Virgile, MD

  • Student in an Organized Health Care Education/Training Program
  • Oceanside, NY
National Provider Identifier
1104482090
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
361 Evans Ave
Oceanside, NY 11572-3831
Phone
(631) 805-5419
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

361 Evans Ave
Oceanside, NY 11572-3831

Mailing address

361 Evans Ave
Oceanside, NY 11572-3831
Phone (631) 805-5419

Other practice location 1

374 Stanhope St
Brooklyn, NY 11237-4434
Phone (718) 963-6734

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220915002496 NY Practitioner - Emergency Medicine 8022493782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.32 of 100Reported as individual
Quality
56.69
Improvement activities
0
Cost
68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Emergency Medical Services, PC CurrentSince Aug 1, 2022 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Aug 1, 2022 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients

Locations

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

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.

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1104482090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 EVANS AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723831",
            "telephone_number": "631-805-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 EVANS AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723831",
            "telephone_number": "631-805-5419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "374 Stanhope St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112374434",
            "country_code": "US",
            "telephone_number": "718-963-6734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIRGILE",
        "first_name": "JENNIFER",
        "middle_name": "RACHEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.