Individual provider Active NPI

Jennifer Marrufo

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1215771654
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
354536 Issued in NY
Practice address
201 E 65TH St
New York, NY 10065-6701
Phone
(332) 263-4314
Fax
(212) 249-7580
NPI assigned
Jun 20, 2024
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 354536 NY Primary

Addresses

Primary practice location

201 E 65TH St
New York, NY 10065-6701

Mailing address

261 Sams Rd Unit C
Meriden, CT 06451-7512
Phone (203) 935-1365

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
I20250513002359 NY Practitioner - Nurse Practitioner 9032637186 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
354536NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JDS Medical Services PC CurrentSince Dec 9, 2025 Accepting new patients
Medical Director Services PC CurrentSince Mar 9, 2025 Accepting new patients

Locations

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

831 Bedford Ave
Brooklyn, NY 11205

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1215771654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 SAMS RD UNIT C",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064517512",
            "telephone_number": "203-935-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 65TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656701",
            "telephone_number": "332-263-4314",
            "fax_number": "212-249-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRUFO",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "354536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.