Individual provider Active NPI

Jacqueline Freycinet, FNP

  • Family Nurse Practitioner
  • Commack, NY
National Provider Identifier
1609582808
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351211 Issued in NY
Practice address
5036 Jericho Tpke Ste 205
Commack, NY 11725-2812
Phone
(631) 385-8000
NPI assigned
Jan 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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 351211 NY Primary

Addresses

Primary practice location

5036 Jericho Tpke Ste 205
Commack, NY 11725-2812

Mailing address

5036 Jericho Tpke Ste 205
Commack, NY 11725-2812
Phone (631) 385-8000

Other practice location 1

18 Woodlake Dr E
Woodbury, NY 11797-2317
Phone (516) 807-6246

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
I20260513001060 NY Practitioner - Nurse Practitioner 9133698749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
351211NYMDRadiation Therapy Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bethpage Medical, PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1609582808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 JERICHO TPKE STE 205",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252812",
            "telephone_number": "631-385-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5036 JERICHO TPKE STE 205",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252812",
            "telephone_number": "631-385-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Woodlake Dr E",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NY",
            "postal_code": "117972317",
            "country_code": "US",
            "telephone_number": "516-807-6246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREYCINET",
        "first_name": "JACQUELINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.