Individual provider Active NPI

Jannatul Noor, PA-C

  • Physician Assistant
  • Manhasset, NY
National Provider Identifier
1609242494
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
300 Community Dr
Manhasset, NY 11030-3816
Phone
(646) 290-1197
NPI assigned
Aug 15, 2015
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Surgical Physician Assistant 363AS0400X NY

Addresses

Primary practice location

300 Community Dr
Manhasset, NY 11030-3816

Mailing address

510 Hempstead Tpke RM 203
West Hempstead, NY 11552-1152

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
I20160923000253 NY Practitioner - Physician Assistant 8123315801 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Urgent Care of Wantagh PLLCGroup PAC ID 9234364027, 40 clinicians

Practice addresses (Care Compare)

3430 Sunrise Hwy
Wantagh, NY 11793-4069
Phone (516) 900-1600

4108 Ave U
Brooklyn, NY 11234-5120
Phone (718) 252-2582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jun 29, 2016 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

Networks

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

Interoperability endpoints

  • Direct secure messaging: jnoor3552166@nychhc.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1439596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1609242494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HEMPSTEAD TPKE RM 203",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115521152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "646-290-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOOR",
        "first_name": "JANNATUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-15",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.