Active NPI
Jesse Condello
- Physician Assistant
- New Hyde Park, NY
National Provider Identifier
1407658156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 033639
- Practice address
- 1 Delaware Dr
New Hyde Park, NY 11042-1116 - Phone
- (631) 751-3000
- NPI assigned
- Mar 25, 2025
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 033639 | NY | Primary |
Addresses
Primary practice location
1 Delaware Dr
New Hyde Park, NY 11042-1116
Mailing address
1 Research Rd
Ridge, NY 11961-2701
Phone (631) 751-3000
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
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Touro Un Col of Osteopathic Medicine, New York, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033639 | NY | MD | Physical Therapist |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- jcondello303006@nyumc.direct-ci.com
Organizations & group practices 1
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.
-
- Specialist
- Port Jefferson Station, NY
- NPI 1396794574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743552000000",
"number": "1407658156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 RESEARCH RD",
"city": "RIDGE",
"state": "NY",
"postal_code": "119612701",
"telephone_number": "631-751-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 DELAWARE DR",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110421116",
"telephone_number": "631-751-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDELLO",
"first_name": "JESSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-25",
"last_updated": "2025-04-02",
"certification_date": "2025-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "033639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.