Individual provider Active NPI

Suzanne Jolly, NP

  • Family Nurse Practitioner
  • Richmond Hill, NY
National Provider Identifier
1114633880
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351172 Issued in NY
Practice address
8900 Van Wyck Expy
Richmond Hill, NY 11418-2897
Phone
(718) 206-6000
NPI assigned
Jan 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 351172 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Richmond Hill, NY 11418-2897

Mailing address

7142 252ND St
Bellerose, NY 11426-2737
Phone (516) 852-0739

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
I20240207000993 NY Practitioner - Nurse Practitioner 5496198426 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
351172NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Jan 1, 2024 Accepting new patients
Jamaica Hospital CurrentSince Jan 1, 2024 Accepting new patients

Locations

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Networks

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

Interoperability endpoints

  • Direct secure messaging: sjolly159992@direct.medisys.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1114633880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7142 252ND ST",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114262737",
            "telephone_number": "516-852-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "SUZANNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.