Jacqueline Grace Paveling, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F300620 Issued in NY

Practice address

University Medical Center Stony BRK
Stony Brook Hospital, Dept Medicine, Hospital 15N-082
Stony Brook, NY 11794-8160

Phone

(631) 444-3318

Fax

(631) 444-1235

NPI assigned

Aug 20, 2007

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

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: jackie.paveling@direct.stonybrookmedicine.edu

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1477746865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY MEDICAL CENTER STONY BRK",
            "address_2": "STONY BROOK HOSPITAL, DEPT MEDICINE, HOSPITAL 15N-082",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948160",
            "telephone_number": "631-444-3318",
            "fax_number": "631-444-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY MEDICAL CENTER STONY BRK",
            "address_2": "STONY BROOK HOSPITAL, DEPT MEDICINE, HOSPITAL 15N-082",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948160",
            "telephone_number": "631-444-3318",
            "fax_number": "631-444-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVELING",
        "first_name": "JACQUELINE",
        "middle_name": "GRACE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F300620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexandra Pedicone, MD
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• Nurse Practitioner in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.

Verify at the official NPI Registry.