Bernice Jackson, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

405214 Issued in NY

Practice address

212 5TH Ave
Bay Shore, NY 11706-6408

Phone

(718) 299-7295

NPI assigned

Sep 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Bernice Butts Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bernice.jackson@ema.eclinicaldirectplus.com

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.

• Essen Medical Associates, PC

  • Legal Medicine
  • Bronx, NY
  • NPI 1366418709
  Medicare reassignment NPD
• Essen Medical Urgicare, PLLC

  • Urgent Care Clinic/Center
  • Bronx, NY
  • NPI 1841607298
  Medicare reassignment NPD
• House Call Medical Services of New York, PLLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1851345946
  Medicare reassignment NPD
• Orenda Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1528663945
  Medicare reassignment NPD
• Essen Medical Associates, PC

  • Podiatrist
  • Bronx, NY
  • NPI 1720799158
  NPD
• Essen Medical Associates,PC

  • Legal Medicine (M.D./D.O.) Physician
  • Jamaica, NY
  • NPI 1700023926
  NPD

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

{
    "created_epoch": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1194493932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 ROUTE 211 E STE 3B367",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109411757",
            "telephone_number": "914-882-0618",
            "fax_number": "914-919-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066408",
            "telephone_number": "718-299-7295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Route 211 E Ste 3B367",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "10941",
            "country_code": "US",
            "telephone_number": "914-882-0618",
            "fax_number": "914-919-1092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BERNICE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-04",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310387",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNICE",
            "last_name": "BUTTS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Islandwide Medical PLLC
• Brandon Isolano, PA
• Doron Israelski, MD
• Robert Issing, PT,DPT
• J & J Home Care & Surgical Supply Inc.
• Janea D Jackson
• Lisa Olivia Jackson, LMSW, CASAC
• Casey Jacobson, PA-C
• Veronique Marie-Andree Jacques, DNP MSN FNP-C
• Omkaar Jaikaran

• Psychiatric/Mental Health Nurse Practitioner in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.

Verify at the official NPI Registry.