Jenna Ann Koroly, MS, RD, CSOWM, CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86073589 Issued in NY

Practice address

186 E 76TH St
New York, NY 10021-2822

Phone

(212) 434-3285

NPI assigned

Apr 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, MA2 enrollments

Enrollment records 2

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: jkoroly51596@northwell.direct-ci.com

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD
• Marcus Avenue Medical PC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1255982542
  Medicare reassignment NPD
• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1568959633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 50TH AVE APT 510W",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015935",
            "telephone_number": "914-274-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212822",
            "telephone_number": "212-434-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROLY",
        "first_name": "JENNA",
        "middle_name": "ANN",
        "credential": "MS, RD, CSOWM, CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "4857",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86073589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Korol, MSN, FNP
• Helen Korol
• Urszula Beata Korol, DDS
• Daniel Korolev
• Aleksandra Koroleva
• Lindsy Koroly, PSYD
• Foday Koroma, FNP-BC
• Doris Korona, NP
• Yannis Koroneos, DMD
• Richard V Korongy, MD

• Registered Dietitian in New York, NY
• Providers in New York, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.