Individual provider Active NPI

Seena Jacob

  • Family Nurse Practitioner
  • Nanuet, NY
National Provider Identifier
1558050161
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F349983-01 Issued in NY
Practice address
15 Norge Ave
Nanuet, NY 10954-1726
Phone
(845) 821-2873
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F349983-01 NY Primary

Addresses

Primary practice location

15 Norge Ave
Nanuet, NY 10954-1726

Mailing address

15 Norge Ave
Nanuet, NY 10954-1726
Phone (845) 821-2873

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
I20230911000196 NY Practitioner - Nurse Practitioner 7810351848 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arcadian Medical Health PCGroup PAC ID 6800388372, 33 clinicians
Genesis Medical Health PCGroup PAC ID 9032308267, 44 clinicians

Practice addresses (Care Compare)

225 Maple Ave
Monsey, NY 10952-2715
Phone (845) 354-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F349983-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Health PC CurrentSince Jul 1, 2023 Accepting new patients
Care Connect Medical P.C. CurrentSince Sep 1, 2023 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

7 Skyline Dr
Ste 250
Hawthorne, NY 10532

225 Maple Ave
Monsey, NY 10952
Phone (845) 352-9000

15 Monsey Blvd
Monsey, NY 10952
Phone (845) 356-3400

476 Christian Herald Rd
Vly Cottage, NY 10989
Phone (845) 268-6861

Networks

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

Organizations & group practices 3

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": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1558050161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 NORGE AVE",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109541726",
            "telephone_number": "845-821-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 NORGE AVE",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109541726",
            "telephone_number": "845-821-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SEENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F349983-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

Verify at the official NPI Registry.