Individual provider Active NPI

Jaimee Anne Carlos, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1154848828
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341207-1 Issued in NY
Practice address
1309 Fulton Ave
Bronx, NY 10456-2412
Phone
(347) 396-6299
Fax
(347) 396-6367
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F341207-1 NY Primary

Addresses

Primary practice location

1309 Fulton Ave
Bronx, NY 10456-2412

Mailing address

4209 28TH St # CN-48
Long Island City, NY 11101-4130
Phone (347) 396-6299

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
I20171016000420 NY Practitioner - Nurse Practitioner 5597030783 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F341207-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of New York Office of Payroll Administration Current Accepting new patients
City of New York Office of Payroll Administration CurrentSince Sep 16, 2025 Accepting new patients
City of New York Office of Payroll Administration Past Accepting new patients
City of New York Office of Payroll Administration Past Accepting new patients

Locations

1309 Fulton Ave
Bronx, NY 10456
Phone (718) 566-3587

295 Flatbush Avenue Ext
Brooklyn, NY 11201
Phone (212) 566-3587

3433 Junction Blvd
Fl 2
Jackson Heights, NY 11372
Phone (718) 396-5134

4209 28th St
#48
Long Island City, NY 11101
Phone (347) 396-6234

2238 5th Ave
New York, NY 10037
Phone (646) 698-4405

Interoperability endpoints

  • Direct secure messaging: jcarlos1369811@nychhc.direct-ci.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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1154848828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 28TH ST # CN-48",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014130",
            "telephone_number": "347-396-6299",
            "fax_number": "347-396-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104562412",
            "telephone_number": "347-396-6299",
            "fax_number": "347-396-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "JAIMEE ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341207-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.