Individual provider Active NPI

Jenna Suzanne Gianelli, NP

  • Adult Health Nurse Practitioner
  • Long Island City, NY
National Provider Identifier
1205351897
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308479 Issued in NY
Practice address
2510 30TH Ave
Long Island City, NY 11102-2448
Phone
(917) 992-4995
NPI assigned
Aug 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 593998 NY
Adult Health Nurse Practitioner 363LA2200X 308479 NY Primary

Addresses

Primary practice location

2510 30TH Ave
Long Island City, NY 11102-2448

Mailing address

2612 166TH St
Flushing, NY 11358-1104
Phone (718) 428-6922

Other practice location 1

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 277-4600

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
I20190206002579 NY Practitioner - Nurse Practitioner 5698013225 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Suite 105
Roslyn, NY 11576-1347
Phone (516) 390-9640

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
593998NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Nov 1, 2020 Accepting new patients
CHS Physician Partners, P.C CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 26, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 26, 2018 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Nov 1, 2020 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients

Locations

2520 30th Ave
Long Island City, NY 11102
Phone (718) 267-4230

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Frnt A
New York, NY 10017

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

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

100 Port Washington Blvd
Ste 105
Roslyn, NY 11576
Phone (516) 390-9640

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

Networks

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

Interoperability endpoints

  • Direct secure messaging: jgianelli27074@direct-chsli.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1205351897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 166TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581104",
            "telephone_number": "718-428-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "917-992-4995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Port Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Roslyn",
            "state": "NY",
            "postal_code": "115761347",
            "country_code": "US",
            "telephone_number": "516-277-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIANELLI",
        "first_name": "JENNA",
        "middle_name": "SUZANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "593998",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.