Individual provider Active NPI

Jessica L Consolmagno, PA-C

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1134479306
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1975 Hylan Blvd
Staten Island, NY 10306-3523
Phone
(718) 667-5400
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1975 Hylan Blvd
Staten Island, NY 10306-3523

Mailing address

1975 Hylan Blvd
Staten Island, NY 10306-3523
Phone (718) 667-5400

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
I20200113002264 NY Practitioner - Physician Assistant 6204059611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians
BP Immediate Medical Care, PCGroup PAC ID 8628295581, 25 clinicians

Practice addresses (Care Compare)

125 Greaves LN
Staten Island, NY 10308-2175
Phone (718) 502-8763

1445 Richmond Ave
Staten Island, NY 10314-1563
Phone (929) 219-0622

1700 Hylan Blvd
Staten Island, NY 10305-1930
Phone (516) 537-9062

2590 Hylan Blvd
Unit a
Staten Island, NY 10306-4368
Phone (718) 502-9879

2935 Veterans Rd W
Suite B
Staten Island, NY 10309-2514
Phone (347) 705-7121

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

3808 14TH Ave
Brooklyn, NY 11218-3610
Phone (718) 972-2424

4316 Amboy Rd
Staten Island, NY 10312-3820
Phone (929) 282-4146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients
Rockland Medical Group, PLLC PastSince Apr 15, 2017 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jessica.consolmagno@ghuc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1134479306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063523",
            "telephone_number": "718-667-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063523",
            "telephone_number": "718-667-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSOLMAGNO",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.