Active NPI
Jene Marie Tesoriero, M.D.
- Pediatrics Physician
- Staten Island, NY
National Provider Identifier
1447571765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 257330
- Practice address
- 2955 Veterans Rd W
Staten Island, NY 10309-2515 - Phone
- (718) 356-6000
- NPI assigned
- Jun 21, 2010
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 257330 | NY | Primary |
Addresses
Primary practice location
2955 Veterans Rd W
Staten Island, NY 10309-2515
Mailing address
501 Correll Ave
Staten Island, NY 10309-4208
Phone (718) 317-0756
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Lij Medical Group at North Nassau, PC | Current | Accepting new patients | |
| Premier Pediatrics of New York, PC | Pediatrics | Past | Accepting new patients |
Locations
70 Glen St
Ste 200
Glen Cove, NY 11542
Phone (516) 484-7893
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Interoperability endpoints
- jenetesoriero@nslijmedgr.allscriptsdirect.net
Organizations & group practices 2
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.
-
- Cardiovascular Disease Physician
- Glen Cove, NY
- NPI 1700175270
-
- Pediatrics Physician
- Staten Island, NY
- NPI 1750973368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277078400000",
"number": "1447571765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 CORRELL AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103094208",
"telephone_number": "718-317-0756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2955 VETERANS RD W",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103092515",
"telephone_number": "718-356-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESORIERO",
"first_name": "JENE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-21",
"last_updated": "2010-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "257330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.