Individual provider Active NPI

Jennifer L Defilippo, PA

  • Physician Assistant
  • Greenacres, FL
National Provider Identifier
1508972670
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006253 Issued in NY
Practice address
6801 Lake Worth Rd
Greenacres, FL 33467-2955
Phone
(561) 693-6444
Fax
(866) 450-1704
NPI assigned
Aug 22, 2006
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006253 NY Primary

Addresses

Primary practice location

6801 Lake Worth Rd
Greenacres, FL 33467-2955

Mailing address

350 County Highway 131
Johnstown, NY 12095-4026
Phone (518) 332-6242

Other identifiers 1

IdentifierTypeStateIssuer
01893654MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051021000664 NY Practitioner - Physician Assistant 9830115450 Reassigns benefits to 2 organizations
I20200918000457 FL Practitioner - Physician Assistant 9830115450

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

204 S Broadway
Saratoga Springs, NY 12866-4570
Phone (518) 226-3288

230 N Genesee St
Utica, NY 13502-2529
Phone (315) 275-3214

233 Saratoga Rd
Glenville, NY 12302-4508
Phone (518) 930-7497

332 S Kingsboro Ave
Gloversville, NY 12078-4612
Phone (518) 752-3221

445 Balltown Rd
Suite 1
Schenectady, NY 12304-2269
Phone (518) 387-3566

4942 State Hwy 30
Suite 100
Amsterdam, NY 12010-7520
Phone (518) 627-6336

573 N Greenbush Rd
Rensselaer, NY 12144-9451
Phone (518) 268-2345

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006253NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince May 22, 2014 Accepting new patients
Saratoga Hospital CurrentSince May 22, 2014 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Aug 28, 2023 Accepting new patients
Wellnow Urgent Care, PC Past Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant Past Accepting new patients
Ny Primary Care Practice, PC Past Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

1867 Empire Blvd
Webster, NY 14580
Phone (585) 347-3689

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1508972670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 COUNTY HIGHWAY 131",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "120954026",
            "telephone_number": "518-332-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672955",
            "telephone_number": "561-693-6444",
            "fax_number": "866-450-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFILIPPO",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01893654",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.