Jacqueline A Ammirata, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2060531 Issued in NY

Practice address

320 Montauk Highway
South Bay OB GYN PC
West Islip, NY 11795-4401

Phone

(631) 587-2500

Fax

(631) 587-0292

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

Specialty

Obstetrics/Gynecology

Education

State University of New York at Stony Brook, School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Associates in Obstetrics and Gynecology University FacultyGroup PAC ID 9032001045, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286
• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (3 of 7)

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: jacqueline.ammirata@sbcm.cernerdirect.com

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.

• University Associates in Obstetrics & Gynecology, University Faculty P

  • Obstetrics & Gynecology Physician
  • Stony Brook, NY
  • NPI 1538114723

  NY, Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  NPD (past)
• Stony Brook Gynecology & Obstetrics, P.C.

  • Obstetrics & Gynecology Physician
  • Setauket, NY
  • NPI 1770550477

  Obstetrics & Gynecology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355

  Hospital

  Care Compare affiliation
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1104938455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 105",
            "address_2": "UNIVERSITY ASSOCIATES OBGYN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-672-8279",
            "fax_number": "631-350-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MONTAUK HIGHWAY",
            "address_2": "SOUTH BAY OB GYN PC",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954401",
            "telephone_number": "631-587-2500",
            "fax_number": "631-587-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMIRATA",
        "first_name": "JACQUELINE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "2060531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01944912",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2507203",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "44G631",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacqueline.ammirata@sbcm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "320 Montauk Highway",
            "address_2": "South Bay OB GYN PC",
            "city": "West Islip",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117954401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Godwin C Amalu, RN
• Louis Leonce Amblard, MD
• American Medical
• American Orthodontic Associates of West Islip,LLC
• Tameshwar Ammar, MD
• Sumeet K Anand, MD
• Romina Patel Anazagasty, PHARMD
• Robyn Andersen
• Jennifer Anderson, LCAT
• Suzanne M Angelillo, FNP

• Obstetrics & Gynecology Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.

Verify at the official NPI Registry.