Jihane Real, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F339249 Issued in NY

Practice address

380 Washington Ave
Roosevelt, NY 11575-1845

Phone

(516) 378-2000

NPI assigned

Jul 8, 2016

Last updated

Oct 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1245682616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 1ST PL",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104029",
            "telephone_number": "646-377-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 WASHINGTON AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751845",
            "telephone_number": "516-378-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAL",
        "first_name": "JIHANE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339249-1",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F339249",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Livia Polise, LCSW
• Tasheena Price
• Paola Andrea Puig, MPH, RD, CDE, CD-N
• Ivette Ramos
• Kaitlyn Emily Rapp, DOT, OTR/L
• Rehab Solutions, Inc.
• Janet Lynn Reilly
• Diana Rivas, M.S., CCC-SLP
• Laura P Rivera-R
• Gloriane Roberson, LMSW

• Primary Care Nurse Practitioner in Roosevelt, NY
• Providers in Roosevelt, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.