Individual provider Active NPI

Jennie Robinson, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1255768719
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341994 Issued in NY
Practice address
645 10TH Ave
New York, NY 10036-2904
Phone
(212) 484-5826
Fax
(212) 265-6565
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 675138 NY
Family Nurse Practitioner 363LF0000X F341994 NY Primary

Addresses

Primary practice location

645 10TH Ave
New York, NY 10036-2904

Mailing address

2300 Olinville Ave Apt 9B
Bronx, NY 10467-7819
Phone (631) 455-1611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171201002227 NY Practitioner - Nurse Practitioner 8729345566 Reassigns benefits to 1 organization
I20201203001667 FL Practitioner - Nurse Practitioner 8729345566 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
675138NYMDRegistered Nurse
F341994NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Dec 7, 2020 Accepting new patients
Ryan-Chelsea Clinton Community Health Center CurrentSince Oct 23, 2017 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Galileo Medical Group, NM PC Past Accepting new patients

Locations

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

645 10th Ave
New York, NY 10036
Phone (212) 265-4500

Networks

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

Interoperability endpoints

  • Direct secure messaging: jennie.robinson@450368864321540.direct.elationemr.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1255768719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 OLINVILLE AVE APT 9B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104677819",
            "telephone_number": "631-455-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100362904",
            "telephone_number": "212-484-5826",
            "fax_number": "212-265-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JENNIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "675138",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.