Active NPI
Jennifer Jdaidani, M.D
- Student in an Organized Health Care Education/Training Program
- Staten Island, NY
National Provider Identifier
1164154027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- North Campus 475 Seaview Ave
Staten Island, NY 10305 - Phone
- (718) 226-8313
- NPI assigned
- Jun 29, 2022
- Last updated
- Feb 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
North Campus 475 Seaview Ave
Staten Island, NY 10305
Mailing address
197 June Street
Worcester, MA 01602
Phone (774) 232-4577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250619000096 | TX | Order and Referring Only - Cardiovascular Disease (Cardiology) | 0446761142 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675641600000",
"number": "1164154027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "197 JUNE STREET",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01602",
"telephone_number": "774-232-4577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NORTH CAMPUS 475 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10305",
"telephone_number": "718-226-8313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JDAIDANI",
"first_name": "JENNIFER",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-29",
"last_updated": "2023-02-06",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.