Individual provider Active NPI

Jill Thompson

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1356670640
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350530 Issued in NY
Practice address
47 Macdonough St
12A
Brooklyn, NY 11216-2332
Phone
(718) 623-2175
NPI assigned
Dec 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 299002 NY
Family Nurse Practitioner 363LF0000X 350530 NY Primary

Addresses

Primary practice location

47 Macdonough St
12A
Brooklyn, NY 11216-2332

Mailing address

47 Macdonough St
12A
Brooklyn, NY 11216-2332

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
I20230320001970 NY Practitioner - Nurse Practitioner 8022482793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bedford Stuyvesant Family Health Center, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Bedford Stuyvesant Family Health Center, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Allied Physicians Group, PLLC Past Accepting new patients

Locations

1413 Fulton St
#0
Brooklyn, NY 11216

1456 Fulton St
Brooklyn, NY 11216
Phone (718) 636-4500

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

1238 Broadway
Brooklyn, NY 11221
Phone (718) 443-2428

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFDFAA
  • Direct secure messaging: jill.thompson.1@29151.direct.athenahealth.com

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": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1356670640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 MACDONOUGH ST",
            "address_2": "12A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MACDONOUGH ST",
            "address_2": "12A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162332",
            "telephone_number": "718-623-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JILL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "299002",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.