Individual provider Active NPI

Jordyn Popple

  • Family Nurse Practitioner
  • Syosset, NY
National Provider Identifier
1306463997
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346005 Issued in NY
Practice address
575 Underhill Blvd Ste 175
Syosset, NY 11791-3417
Phone
(516) 302-7679
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 346005 NY Primary

Addresses

Primary practice location

575 Underhill Blvd Ste 175
Syosset, NY 11791-3417

Mailing address

2000 Nantucket Rd
Merrick, NY 11566-1609

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210127001279 NY Practitioner - Nurse Practitioner 5890109144 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Michael S. Cohen MD PCGroup PAC ID 4981040441, 4 clinicians
Brain and Spine Surgeons of New York PCGroup PAC ID 7113818139, 24 clinicians

Practice addresses (Care Compare)

575 Underhill Blvd
Suite 175
Syosset, NY 11791-3417
Phone (516) 921-6780

Merit-based Incentive Payment System (MIPS)

Final score
86.13 of 100Reported as group
Quality
95
Improvement activities
40
Cost
60.42

Merit-based Incentive Payment System (MIPS)

Final score
93.58 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
346005NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brain & Spine Surgeons of New York PC CurrentSince Aug 1, 2025 Accepting new patients
Michael S Cohen MD PC CurrentSince Dec 27, 2023 Accepting new patients

Locations

106 Crystal Brook Hollow Rd
#A
Port Jeff Sta, NY 11776
Phone (631) 509-5250

106 Crystal Brook Hollow Rd
Ste A
Port Jefferson Station, NY 11776
Phone (631) 509-5250

575 Underhill Blvd
Ste 175
Syosset, NY 11791
Phone (516) 704-7004

4 Westchester Park Dr
Fl 4
White Plains, NY 10604
Phone (914) 948-3008

Networks

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

Organizations & group practices 3

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": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1306463997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NANTUCKET RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 UNDERHILL BLVD STE 175",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913417",
            "telephone_number": "516-302-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPLE",
        "first_name": "JORDYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.