Individual provider Active NPI

Jacqueline Marie Greeves

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1609386473
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342351 Issued in NY
Practice address
1468 Madison Ave
New York, NY 10029
Phone
(212) 241-0620
NPI assigned
Oct 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2018

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 342351 NY Primary

Addresses

Primary practice location

1468 Madison Ave
New York, NY 10029

Mailing address

1240 Park Ave Apt 4C
New York, NY 10128-1756
Phone (301) 455-6105

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
I20180108002180 NY Practitioner - Nurse Practitioner 5799044285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 658-8552

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 11, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 11, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • 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 6

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": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1609386473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 PARK AVE APT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281756",
            "telephone_number": "301-455-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEVES",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.