Jacqueline Corvino

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

018265-1 Issued in NY

Practice address

830 Park Ave
Huntington, NY 11743-4543

Phone

(631) 271-5800

NPI assigned

Dec 1, 2014

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

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Li Urgent Care PCGroup PAC ID 8426273210, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8960/brand/1/csg/1/fhir/r4
• Direct secure messaging: jacqueline.corvino.1@8960.direct.athenahealth.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.

• Li Urgent Care PC

  • Urgent Care Clinic/Center
  • West Babylon, NY
  • NPI 1184047870
  Medicare reassignment Care Compare group
• Anthony J Antonucci M D P C

  • Internal Medicine Physician
  • Huntington, NY
  • NPI 1083751879
  Medicare reassignment
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1124425509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434543",
            "telephone_number": "631-271-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434543",
            "telephone_number": "631-271-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORVINO",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018265-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Cordaro, CCC-SLP
• Patrick Thomas Corley, PT, DPT
• Kerri Corrigan
• Robert Anthony Corso I, R.N.
• Marina Cortese, LAC
• Stacey Coschignano, LMSW
• Rebecca Costa, LCSW
• Christine June Costello, NP
• Jaime Costello, MSW
• Julie Florence Cotter

• Physician Assistant in Huntington, NY
• Providers in Huntington, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.