Jessie Nackman, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

016871 Issued in NY

Practice address

200 Garden City PLZ
Suite 100
Garden City, NY 11530-3301

Phone

(516) 663-6400

Fax

(516) 307-8840

NPI assigned

Sep 6, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1134554397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GARDEN CITY PLZ",
            "address_2": "SUITE 100",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303301",
            "telephone_number": "516-663-6400",
            "fax_number": "516-307-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GARDEN CITY PLZ",
            "address_2": "SUITE 100",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303301",
            "telephone_number": "516-663-6400",
            "fax_number": "516-307-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACKMAN",
        "first_name": "JESSIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "016871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Garden City, NY
• Providers in Garden City, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.