NPIMap

Individual provider Active NPI

Jennifer M Weston, PA-C, MS, RD

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1154545895
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023991 Issued in NY
Practice address
150 55TH St
Brooklyn, NY 11220-2508
Phone
(718) 630-7000
NPI assigned
Apr 12, 2007
Reactivated
Nov 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2400 MA
Physician Assistant 363A00000X 023991 NY Primary

Addresses

Primary practice location

150 55TH St
Brooklyn, NY 11220-2508

Mailing address

20302 Aspenwood Dr
Plainview, NY 11803-2145

Other practice location 1

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191108000807 NY Practitioner - Physician Assistant 4385076579 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians
St Charles Hospital CorpGroup PAC ID 6103733050, 62 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6000

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
023991NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Medical CurrentSince Sep 21, 2021 Accepting new patients
New York University CurrentSince Jan 23, 2024 Accepting new patients
CHS Physician Partners, P.C CurrentSince Sep 21, 2021 Accepting new patients
CHS Physician Partners, PC CurrentSince Sep 21, 2021 Accepting new patients
New York University CurrentSince Jan 23, 2024 Accepting new patients
Mercy Medical Center CurrentSince Sep 21, 2021 Accepting new patients
Mercy Medical Center CurrentSince Sep 21, 2021 Accepting new patients
Nrad Medical Associates, PC Past Accepting new patients
Bethpage Medical, PLLC Past Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

16303 Horace Harding Expy
Ste 100
Fresh Meadows, NY 11365
Phone (718) 454-4600

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Interoperability endpoints

  • Direct secure messaging: jweston608629@nyumc.direct-ci.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1154545895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20302 ASPENWOOD DR",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118032145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Belle Terre Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771928",
            "country_code": "US",
            "telephone_number": "631-474-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESTON",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "PA-C, MS, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "deactivation_date": "2019-10-09",
        "reactivation_date": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2400",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.