Active NPI
Jennifer Duperval, PA-C
- Physician Assistant
- Roslyn, NY
National Provider Identifier
1306273677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 016919-1
- Practice address
- 100 Port Washington Blvd
Roslyn, NY 11576-1347 - Phone
- (516) 562-6000
- NPI assigned
- Oct 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 016919-1 | NY | Primary |
Addresses
Primary practice location
100 Port Washington Blvd
Roslyn, NY 11576-1347
Mailing address
60-33 Marathon Parkway
2ND Floor
Little Neck, NY 11362
Phone (516) 993-3169
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016919-1 | NY | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420588800000",
"number": "1306273677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60-33 MARATHON PARKWAY",
"address_2": "2ND FLOOR",
"city": "LITTLE NECK",
"state": "NY",
"postal_code": "11362",
"telephone_number": "516-993-3169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PORT WASHINGTON BLVD",
"city": "ROSLYN",
"state": "NY",
"postal_code": "115761347",
"telephone_number": "516-562-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPERVAL",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-02",
"last_updated": "2015-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "016919-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roslyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.