Jessica Prudencio, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F406381-01 Issued in NY

Practice address

506 Stewart Ave
Garden City, NY 11530-4706

Phone

(516) 705-3400

NPI assigned

Jan 23, 2025

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

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Medical CenterGroup PAC ID 4082518006, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

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.

• Mercy Medical Center

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1619245610
  Medicare reassignment Care Compare group NPD
• Mercy Medical Center

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1104097294
  NPD
• Mercy Medical Center

  • Psychiatric Hospital Unit
  • Rockville Centre, NY
  • NPI 1487698544
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Medical Center

  • Psychiatric Hospital Unit
  • Rockville Centre, NY
  • NPI 1427017854
  Care Compare affiliation
• Mercy Medical Center

  • Rehabilitation Hospital Unit
  • Rockville Centre, NY
  • NPI 1598724924
  Care Compare affiliation
• Mercy Medical Center

  • General Acute Care Hospital
  • Rockville Centre, NY
  • NPI 1659330173
  Care Compare affiliation

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761436800000",
    "number": "1215749486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304706",
            "telephone_number": "516-728-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304706",
            "telephone_number": "516-705-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDENCIO",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-10-26",
        "certification_date": "2025-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F406381-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Orthopedic and Sports Physical Therapy PC
• Profile Physical Therapy & Wellness
• Prohealth Dental PLLC
• Timothy William Prohinsie, MS, ATC
• Prophase Diagnostics Ny, Inc
• Heather Marie Prussen, P.A.
• Psychological Diagnostic Evaluations of New York
• Dina Marie Puglissi, RPAC
• Heather Puleo, PA
• Sapna Punj, DDS

• Psychiatric/Mental Health Nurse Practitioner in Garden City, NY
• Providers in Garden City, 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 Oct 26, 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.
• 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.