Jennifer Ann Wagner, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

334755 Issued in NY

Practice address

255 Fifth Avenue
Nyack, NY 10960-1824

Phone

(845) 362-1750

Fax

(845) 362-1577

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Plains Medical Diagnostic Services, PCGroup PAC ID 5395918932, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nyack Hospital Hospital, Nyack, NY, CCN 330104

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: jenwagner@hiemail.healtheconnections.org

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.

• White Plains Medical Diagnostic Services, PC

  • Internal Medicine Physician
  • Nyack, NY
  • NPI 1689955338
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Montefiore Nyack Hospital

  • General Acute Care Hospital
  • Nyack, NY
  • NPI 1104808062
  Care Compare affiliation

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1346459591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 FIFTH AVENUE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601824",
            "telephone_number": "845-362-1750",
            "fax_number": "845-362-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 FIFTH AVENUE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601824",
            "telephone_number": "845-362-1750",
            "fax_number": "845-362-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "334755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shani Varghese
• Andrea Ventouris
• Assunta G. Vitti, PH.D.
• Joseph Anthony Vittorio, M.D.
• Belisa Vranich
• Naji Abdul Wajid, D.O.
• Walgreen Co
• Robin J Wallace, LCSW-R
• Jacob Wallach, D.D.S.
• Kristin Walsh

• Family Nurse Practitioner in Nyack, NY
• Providers in Nyack, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.

Verify at the official NPI Registry.