Jennifer W Gillin, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015710 Issued in NY

Practice address

99B Main St
Westhampton Beach, NY 11978-2607

Phone

(631) 288-3969

NPI assigned

Aug 31, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Jennifer W Ketner Professional name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Hamptons NP in Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Westhampton Beach, NY
  • NPI 1366147431
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215049093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195",
            "city": "WESTHAMPTON",
            "state": "NY",
            "postal_code": "119770195",
            "telephone_number": "631-682-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99B MAIN ST",
            "city": "WESTHAMPTON BEACH",
            "state": "NY",
            "postal_code": "119782607",
            "telephone_number": "631-288-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIN",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "497164",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI/EMPIRE",
            "identifier": "73361570",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KETNER",
            "middle_name": "W",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kimberly C Galway, LCAT
• Melissa Garcia
• Kaitlin Gebhardt, LCSW
• Matt Geller, LMSW
• Genie Portillo LCSW-R, Casc
• Lori H Giorlando
• Joseph Robert Glielmo, RPH
• Good Works Therapy Services, Inc.
• Kimberly Marie Gordon, LPN
• James E Grant, CASAC

• Clinical Psychologist in Westhampton Beach, NY
• Providers in Westhampton Beach, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.