Individual provider Active NPI

Jeanne Paule Nandkishorelal, NP

  • Gerontology Nurse Practitioner
  • Oceanside, NY
National Provider Identifier
1558128652
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F311714-01 Issued in NY
Practice address
1 Healthy Way
Oceanside, NY 11572-1551
Phone
(718) 240-6000
NPI assigned
Mar 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X F311714-01 NY Primary

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

1 Healthy Way
Oceanside, NY 11572-1551
Phone (518) 512-7144

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
I20241016002852 NY Practitioner - Nurse Practitioner 6204368160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

1305 York Ave
New York, NY 10021-5663
Phone (646) 962-5325

525 E 68TH St
New York, NY 10065-4870
Phone (646) 962-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311714NYMDSurgery Physician
F311714-01NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Oct 7, 2024 Accepting new patients
Weill Medical College of Cornell CurrentSince Oct 7, 2024 Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

170 William St
New York, NY 10038
Phone (212) 238-0100

1305 York Ave
Fl 4
New York, NY 10021
Phone (646) 962-4000

156 William St
Fl 6
New York, NY 10038
Phone (646) 962-2620

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Gpo 5907
New York, NY 10087

Networks

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

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1558128652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "518-512-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "718-240-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDKISHORELAL",
        "first_name": "JEANNE PAULE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F311714-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.