Individual provider Active NPI

Jasmine Beaujuin, RN

  • Family Nurse Practitioner
  • Rosedale, NY
National Provider Identifier
1376866624
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344103 Issued in NY
Practice address
13814 Caney LN
Rosedale, NY 11422-2618
Phone
(347) 238-5629
NPI assigned
Mar 1, 2010
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344103 NY Primary
Registered Nurse 163W00000X 614501 NY

Addresses

Primary practice location

13814 Caney LN
Rosedale, NY 11422-2618

Mailing address

13814 Caney LN
Rosedale, NY 11422-2618
Phone (347) 238-5629

Other identifiers 1

IdentifierTypeStateIssuer
614501OtherNYNYS RN LICENSE

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
I20250109002846 NY Practitioner - Nurse Practitioner 3577091149 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
614501NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Dec 1, 2024 Accepting new patients
Jamaica Hospital CurrentSince Dec 1, 2024 Accepting new patients

Locations

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: jbeaujuin1437472@nychhc.direct-ci.com
  • Direct secure messaging: jbeaujuin316487@direct.medisys.org

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": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1376866624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13814 CANEY LN",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222618",
            "telephone_number": "347-238-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13814 CANEY LN",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222618",
            "telephone_number": "347-238-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUJUIN",
        "first_name": "JASMINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344103",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "614501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS RN LICENSE",
            "identifier": "614501",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

Verify at the official NPI Registry.