Jennifer Marie Enderline, AG-ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

220412 Issued in AZ

Practice address

169 Madison Ave Ste 2817
New York, NY 10016-5101

Phone

(888) 553-2823

Fax

(888) 553-2823

NPI assigned

Dec 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Jennifer Marie White Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, FL, SC, CA, AZ, NY, DE, PA, OH, DC, VA, MA12 enrollments

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 12

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Post Acute Specialists LLCGroup PAC ID 1951676568, 180 clinicians

Post Acute Specialists of Massachusetts PLLCGroup PAC ID 0244640498, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Camillus Residential Health Care Facility Nursing home, Syracuse, NY, CCN 335283
• Notre Dame Long Term Care Center Nursing home, Worcester, MA, CCN 225577

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 42)

Networks

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

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.

• Post Acute Specialists of Massachusetts PLLC

  • Internal Medicine Physician
  • Taunton, MA
  • NPI 1104438480
  Medicare reassignment Care Compare group NPD
• Post Acute Specialists, LLC

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1114441565

  DC, DE, FL, NC, NY, OH, PA, SC, VA

  Medicare reassignment Care Compare group NPD
• Five Star Medical Office PC

  • Internal Medicine Physician
  • Forest Hills, NY
  • NPI 1760731459
  Medicare reassignment NPD
• Ca Post Acute Specialists PC

  • Family Medicine Physician
  • Redding, CA
  • NPI 1710401302
  Medicare reassignment NPD
• Careathome Medical Practice (Ma), P.C.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1477123321
  Medicare reassignment NPD
• Caringathome, LLC

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1912595828
  Medicare reassignment NPD
• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369
  Medicare reassignment NPD
• Pai Participant 1 LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1093371312

  FL

  Medicare reassignment NPD
• Pai Participant 29, P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Lexington, NC
  • NPI 1245813757
  Medicare reassignment NPD
• Perfect Health PC

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1861815300
  Medicare reassignment NPD
• Urban Family Practice PC

  dba Grace at Home

  • In Home Supportive Care Agency
  • Baltimore, MD
  • NPI 1164594099

  NY

  Medicare reassignment NPD
• Careathome Medical Practice Ky

  • Family Medicine Physician
  • New York, NY
  • NPI 1467040345

  AZ, OH

  Medicare reassignment

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

• St. Camillus Residential Health Care Facility

  • Skilled Nursing Facility
  • Syracuse, NY
  • NPI 1659396943

  Nursing home

  Care Compare affiliation
• St. Camillus Residential Health Care Facility

  • Multi-Specialty Clinic/Center
  • Syracuse, NY
  • NPI 1942341532

  Nursing home

  Care Compare affiliation
• Notre Dame Health Care Center,Inc

  • Skilled Nursing Facility
  • Worcester, MA
  • NPI 1396736930

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1356813653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE STE 2817",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "888-553-2823",
            "fax_number": "888-553-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE STE 2817",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "888-553-2823",
            "fax_number": "888-553-2823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2723 S State St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481046188",
            "country_code": "US",
            "telephone_number": "888-553-2823",
            "fax_number": "888-553-2823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 S Ashley Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336025300",
            "country_code": "US",
            "telephone_number": "888-553-2823",
            "fax_number": "888-553-2823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5851 Legacy Cir Fl 6",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750245966",
            "country_code": "US",
            "telephone_number": "888-553-2823",
            "fax_number": "888-553-2823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4821 N Stone Ave",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857045727",
            "country_code": "US",
            "telephone_number": "520-314-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 John St Ste M-318",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075383",
            "country_code": "US",
            "telephone_number": "269-349-9745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENDERLINE",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "433088",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11028038",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704407614",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1141255",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "220412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356813653",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WHITE",
            "middle_name": "MARIE",
            "credential": "AG-ACNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Acute Care Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.