Jacqueline Concepcion, AGNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F308226-1 Issued in NY

Practice address

410 Lakeville Rd Ste 107
New Hyde Park, NY 11042-1102

Phone

(516) 465-5400

NPI assigned

Jul 31, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Ibarra Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1467976506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 TWIG LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD STE 107",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421102",
            "telephone_number": "516-465-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F308226-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "IBARRA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lizelle Comfort, MD
• Frank Joseph Commisso, PA
• Community Development of Asian American
• Heidi Como, RD
• Ederliza Galang Concepcion, MD
• Jesse Condello
• Maria Condello, MS, CCC-SLP
• Megan Connolly
• Jamie Contreras, DMD
• Thomas Patrick Conway, DO

• Primary Care Nurse Practitioner in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.