Individual provider Active NPI

Jene Marie Tesoriero, M.D.

  • Pediatrics Physician
  • Staten Island, NY
National Provider Identifier
1447571765
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
257330 Issued in NY
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

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250610001049 NY Practitioner - Pediatric Medicine 6901316942 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Lij Medical Group at North Nassau, PC CurrentSince Jul 10, 2025 Accepting new patients
Premier Pediatrics of New York, PC Pediatrics PastSince Feb 7, 2021 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.