Individual provider Active NPI

Rehana Jaggernauth, MSN, RN,FNP-C

  • Nurse Practitioner
  • Queens Village, NY
National Provider Identifier
1528213907
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
354402 Issued in NY
Practice address
9031 210TH St
Queens Village, NY 11428-1018
Phone
(718) 776-3744
NPI assigned
Nov 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 354402 NY Primary

Addresses

Primary practice location

9031 210TH St
Queens Village, NY 11428-1018

Mailing address

3 Mary LN
Greenvale, NY 11548-1127
Phone (718) 776-3744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
354402NYMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1528213907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARY LN",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481127",
            "telephone_number": "718-776-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9031 210TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281018",
            "telephone_number": "718-776-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGGERNAUTH",
        "first_name": "REHANA",
        "name_prefix": "Ms.",
        "credential": "MSN, RN,FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-26",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "354402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.