Jacqueline Sherry Fern, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

175358 Issued in NY

Practice address

2 Medical Dr
Suite a
Port Jefferson Station, NY 11776-1598

Phone

(631) 928-1555

Fax

(631) 928-1570

NPI assigned

Dec 7, 2005

Sex

Female

Sole proprietor

No

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

New York University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Winston Dermatology Associates, PCGroup PAC ID 4688563166, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Winston Dermatology Associates, PC

  • Dermatology Physician
  • Port Jefferson Station, NY
  • NPI 1710988613
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1235114752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761598",
            "telephone_number": "631-928-1555",
            "fax_number": "631-928-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761598",
            "telephone_number": "631-928-1555",
            "fax_number": "631-928-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERN",
        "first_name": "JACQUELINE",
        "middle_name": "SHERRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "175358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen R. Feldman, LCSW
• Peter S. Felpo
• Cara K Fenoy, LPN
• Maureen T Fenoy, LPN
• Natasha Fera, LMSW
• James Fernandes II
• Ana Maria Fernandez
• Jessica Fernandez
• Jennifer B. Ferraro, N.P.P.
• Maria Fatima Ferreira

• Dermatology Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.