Jennifer Ellner, PA-C, MPAS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

23017431 Issued in NY

Practice address

259 1St St
Mineola, NY 11501-3957

Phone

(516) 663-8312

NPI assigned

Mar 1, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

91.79

Promoting interoperability

100

Improvement activities

40

Cost

75.18

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment NPD
• Winthrop Community Medical Affiliates, P.C.

  • Surgery Physician
  • Mineola, NY
  • NPI 1649651498
  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

{
    "created_epoch": "1393632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1558786491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLNER",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-01",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "23017431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jellner307477@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "259 1st St",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Carrie Ann Engblom VIII, P.T.

• Physician Assistant in Mineola, NY
• Providers in Mineola, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.