Jennifer Pothen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

315296 Issued in NY

Practice address

1 Dakota Dr Ste 218
New Hyde Park, NY 11042-1136

Phone

(516) 488-9700

Fax

(516) 488-8826

NPI assigned

Jul 17, 2013

Last updated

Jul 17, 2024By 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 2

Addresses

Other identifiers 2

Other names 1

• Jennifer Varghese Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Optum Medical Care, P.C.

  dba CareMount Medical, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  Medicare reassignment

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1255772307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 TOWN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602315",
            "telephone_number": "860-892-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DAKOTA DR STE 218",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421136",
            "telephone_number": "516-488-9700",
            "fax_number": "516-488-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHEN",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "52266",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "315296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008046940",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07530096",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VARGHESE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly R Porta, PA
• Cecily Portillo, PH.D.
• Joel Evan Portnoy, M.D.
• Dominick Posillico, PA
• Agustin Posso, MD
• Maria G Pouliezos-Karayiannis, D.M.D
• Sheilah Rose Power, MA, CCC-SLP, TSSLD
• Kaylin Prasad, DNP, FNP-BC
• Sujata Prasad, D.D.S.
• Ashley Michelle Prawer, NP

• Family Medicine Physician in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.