Individual provider Active NPI

Jane Ann Koop, ANP-C

  • Adult Health Nurse Practitioner
  • Babylon, NY
National Provider Identifier
1528025434
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
303829 Issued in NY
Practice address
500 W Main St
Suite 110
Babylon, NY 11702-3027
Phone
(631) 669-4500
Fax
(631) 669-7710
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 303829 NY Primary

Addresses

Primary practice location

500 W Main St
Suite 110
Babylon, NY 11702-3027

Mailing address

272 Johnson Ave
Sayville, NY 11782-1144
Phone (631) 589-4624

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080219000654 NY Practitioner - Nurse Practitioner 4284718982 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
303829NYMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Medical CurrentSince Jan 3, 2010 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jan 25, 2018 Accepting new patients
Good Samaritan Hospital CurrentSince Jan 3, 2010 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jan 25, 2018 Accepting new patients

Locations

100 Nicolls Rd
#13202
Stony Brook, NY 11794

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: jane.koop@direct.stonybrookmedicine.edu

Organizations & group practices 6

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528025434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 JOHNSON AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821144",
            "telephone_number": "631-589-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "SUITE 110",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023027",
            "telephone_number": "631-669-4500",
            "fax_number": "631-669-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOP",
        "first_name": "JANE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

Verify at the official NPI Registry.