Active NPI
Jane F Moysak, FNP-BC
- Family Nurse Practitioner
- Port Chester, NY
National Provider Identifier
1326206293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F331232-1
- Practice address
- 5 Grace Church St
Port Chester, NY 10573-4911 - Phone
- (914) 937-8899
- NPI assigned
- May 28, 2008
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F331232-1 | NY | Primary |
Addresses
Primary practice location
5 Grace Church St
Port Chester, NY 10573-4911
Mailing address
5 Grace Church St
Port Chester, NY 10573-4911
Phone (914) 937-8899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03050566 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170111001026 | NY | Practitioner - Nurse Practitioner | 7214000991 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Open Door Family Medical Center Inc
Practice addresses (Care Compare)
5 Grace Church St
Port Chester, NY 10573-4911
Phone (914) 632-2737
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F331232-1 | NY | MD | Family Nurse Practitioner |
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open Door Family Medical Center Inc | Current | Accepting new patients | |
| Open Door Family Medical Center, Inc. | Current | Accepting new patients | |
| Open Door Family Medical Center, Inc. | Past | Accepting new patients | |
| NP Care, LLC | Past | Accepting new patients |
Locations
165 Main St
Ossining, NY 10562
Phone (914) 941-1263
5 Grace Church St
Port Chester, NY 10573
Phone (914) 937-8899
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EAJCAA
- jane.moysak@odfmc.eclinicaldirectplus.com
Organizations & group practices 8
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.
-
- Federally Qualified Health Center (FQHC)
- Port Chester, NY
- NPI 1285893719
NY
-
- Federally Qualified Health Center (FQHC)
- Mount Kisco, NY
- NPI 1629237151
-
- Federally Qualified Health Center (FQHC)
- Ossining, NY
- NPI 1467487637
-
- Federally Qualified Health Center (FQHC)
- Sleepy Hollow, NY
- NPI 1619136140
-
- Federally Qualified Health Center (FQHC)
- Saugerties, NY
- NPI 1780166645
-
- Federally Qualified Health Center (FQHC)
- Brewster, NY
- NPI 1003152240
-
- Federally Qualified Health Center (FQHC)
- Mamaroneck, NY
- NPI 1487194155
-
- Nurse Practitioner
- Shelton, CT
- NPI 1386693182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1326206293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 GRACE CHURCH ST",
"city": "PORT CHESTER",
"state": "NY",
"postal_code": "105734911",
"telephone_number": "914-937-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 GRACE CHURCH ST",
"city": "PORT CHESTER",
"state": "NY",
"postal_code": "105734911",
"telephone_number": "914-937-8899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYSAK",
"first_name": "JANE",
"middle_name": "F",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-28",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F331232-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03050566",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Chester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.