NPIMap

Individual provider Active NPI

Jennifer Peace Polatchek, AGPCNP

  • Gerontology Nurse Practitioner
  • New York, NY
National Provider Identifier
1245793900
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
309135 Issued in NY
Practice address
535 East 70TH Street
HSS-App Departent
New York, NY 10021
Phone
(646) 714-6514
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 309135 NY
Gerontology Nurse Practitioner 363LG0600X 309135 NY Primary

Addresses

Primary practice location

535 East 70TH Street
HSS-App Departent
New York, NY 10021

Mailing address

535 East 70TH Street
HSS-App Departent
New York, NY 10021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211202001328 NY Practitioner - Nurse Practitioner 6002243672 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prominis Medical Services PCGroup PAC ID 9537124441, 43 clinicians

Practice addresses (Care Compare)

332 Dekalb Ave
Brooklyn, NY 11205-3820
Phone (718) 852-5252

535 E 70TH St
New York, NY 10021-4823
Phone (212) 774-7598

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309135NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dial Doc Now Medical Group PC CurrentSince Dec 1, 2021 Accepting new patients
Parkway Pain Care & Rehabilitation P.C. CurrentSince Feb 13, 2024 Accepting new patients
Prominis Medical Services PC CurrentSince Apr 11, 2025 Accepting new patients
New York Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Apr 29, 2024 Accepting new patients
New York Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Apr 29, 2024 Accepting new patients
Rd Medical Professional Services PC CurrentSince Mar 1, 2022 Accepting new patients
Comprehensive Women's Health of N.Y. PLLC PastSince Jan 9, 2009 Accepting new patients

Locations

1555 Rockaway Pkwy
Brooklyn, NY 11236
Phone (718) 307-5460

4303 14th Ave
Brooklyn, NY 11219
Phone (718) 436-7800

332 DeKalb Ave
Brooklyn, NY 11205
Phone 7185825252101

10311 68th Dr
Forest Hills, NY 11375
Phone (347) 642-5315

6829 Myrtle Ave
Glendale, NY 11385
Phone (718) 366-2242

535 E 70th St
New York, NY 10021

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

612 Corporate Way
Ste 2M
Vly Cottage, NY 10989
Phone (718) 362-1403

612 Corporate Way
Ste 1M
Vly Cottage, NY 10989
Phone (718) 732-3634

65 Ashburton Ave
Yonkers, NY 10701
Phone (914) 729-4916

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1245793900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 EAST 70TH STREET",
            "address_2": "HSS-APP DEPARTENT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 EAST 70TH STREET",
            "address_2": "HSS-APP DEPARTENT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "646-714-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLATCHEK",
        "first_name": "JENNIFER",
        "middle_name": "PEACE",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "309135",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "309135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.