Active NPI
Jeevamole Varughese
- Family Nurse Practitioner
- Jamaica, NY
National Provider Identifier
1407434558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F-345495-01
- Practice address
- 8268 164TH St
Jamaica, NY 11432-1121 - Phone
- (646) 280-7312
- NPI assigned
- Mar 31, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F-345495-01 | NY | Primary |
Addresses
Primary practice location
8268 164TH St
Jamaica, NY 11432-1121
Mailing address
8248 267TH St
Glen Oaks, NY 11004-1715
Phone (646) 280-7312
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230810002505 | NY | Order and Referring Only - Nurse Practitioner | 9931561735 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F-345495-01 | NY | MD | Family Nurse Practitioner |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1407434558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8248 267TH ST",
"city": "GLEN OAKS",
"state": "NY",
"postal_code": "110041715",
"telephone_number": "646-280-7312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8268 164TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114321121",
"telephone_number": "646-280-7312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARUGHESE",
"first_name": "JEEVAMOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-31",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F-345495-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.