Individual provider Active NPI

Jennifer Renous, CNM

  • Midwife
  • Islandia, NY
National Provider Identifier
1326794363
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
F002113 Issued in NY
Practice address
3001 Express Dr N
Islandia, NY 11749-5301
Phone
(631) 292-6747
NPI assigned
Feb 28, 2022
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F002113 NY Primary

Addresses

Primary practice location

3001 Express Dr N
Islandia, NY 11749-5301

Mailing address

938 Washington St
Baldwin, NY 11510-4823
Phone (516) 765-5136

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715000129 NY Practitioner - Certified Nurse Midwife (CNM) 5698156131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

752 Park Ave
Huntington, NY 11743-3900
Phone (631) 470-8940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F002113NYMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Lij OB GYN PC CurrentSince Jun 1, 2022 Accepting new patients
North Shore-Lij Medical PC CurrentSince Apr 15, 2023 Accepting new patients
North Shore - Lij Medical PC CurrentSince Apr 15, 2023 Accepting new patients

Locations

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

752 Park Ave
Huntington, NY 11743
Phone (631) 271-9017

3001 Express Dr N
Islandia, NY 11749
Phone (631) 292-6747

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

222 E Middle Country Rd
Ste 114
Smithtown, NY 11787
Phone (631) 292-6748

Networks

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

Interoperability endpoints

  • Direct secure messaging: jenniferrenous@nslijmedgr.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1326794363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 WASHINGTON ST",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104823",
            "telephone_number": "516-765-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EXPRESS DR N",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495301",
            "telephone_number": "631-292-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENOUS",
        "first_name": "JENNIFER",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F002113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islandia, NY

Sources for this page

Verify at the official NPI Registry.