Individual provider Active NPI

Jennifer Ray-Terry, RPA-C

  • Physician Assistant
  • Hempstead, NY
National Provider Identifier
1174747091
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004039-1 Issued in NY
Practice address
540 Fulton Ave
Hempstead, NY 11550-4364
Phone
(516) 750-2500
Fax
(516) 483-3592
NPI assigned
Apr 12, 2007
Last updated
Sep 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004039-1 NY Primary

Addresses

Primary practice location

540 Fulton Ave
Hempstead, NY 11550-4364

Mailing address

540 Fulton Ave
Hempstead, NY 11550-4364
Phone (516) 750-2500

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
I20040415001084 NY Practitioner - Physician Assistant 7012902497 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004039NYMDDiagnostic Radiology Physician
004039-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of the Southern Finger Lakes Inc. Past Accepting new patients

Organizations & group practices 2

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.

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": "1379548800000",
    "number": "1174747091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 FULTON AVE",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504364",
            "telephone_number": "516-750-2500",
            "fax_number": "516-483-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 FULTON AVE",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504364",
            "telephone_number": "516-750-2500",
            "fax_number": "516-483-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY-TERRY",
        "first_name": "JENNIFER",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "004039-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hempstead, NY

Sources for this page

Verify at the official NPI Registry.