Jessica L Amaya Gonzalez, ADULT/GERONTOLOGY NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F308225-1 Issued in NY

Practice address

100 Port Washington Blvd
Roslyn, NY 11576-1353

Phone

(516) 562-6766

NPI assigned

Dec 29, 2017

Last updated

Apr 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Suffolk Medical PCGroup PAC ID 0244396349, 204 clinicians

Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: jmolinaamaya27042@direct-chsli.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment Care Compare group NPD
• Southwest Suffolk Medical, P.C.

  • Surgical Oncology Physician
  • Smithtown, NY
  • NPI 1104096049
  Medicare reassignment Care Compare group NPD
• Southwest Suffolk Medical PC

  dba Samaritan Primary Care

  • Family Medicine Physician
  • Lindenhurst, NY
  • NPI 1770919763
  NPD

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

• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1144737164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-562-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-562-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAYA GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "ADULT/GERONTOLOGY NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-29",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308225-1",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F308225-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista M Altman, LCSW
• Mel Altman, DDS
• Miriam I Altman, M.S., CCC/SLP
• Selma Alushaj, PA
• Am-PM Family Footcare PLLC
• Joseph Anthony Ametrano, MD
• Maria Ametrano, PA
• Viren Gordhanbhai Amin, M.D.
• Anastasia C. Anagnostopoulos, M.D.
• Ankur Anand, M.D.

• Adult Health Nurse Practitioner in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.