Jennifer Lee Zajac

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

420663 Issued in NY

Practice address

11050 Mt Belvedere Blvd
USA Meddac
Fort Drum, NY 13602-5004

Phone

(315) 785-4624

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 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

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Planned Parenthood of the North Country New York, Inc.Group PAC ID 3476531898, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: jennifer.zajac.p2@direct.usppny.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jenniferz@hiemail.healtheconnections.org

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.

• Planned Parenthood of the North Country New York, Inc.

  • Ambulatory Family Planning Facility
  • Watertown, NY
  • NPI 1407907215
  Medicare reassignment Care Compare group
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Medicare reassignment
• Planned Parenthood of Central and Western New York, Inc

  • Ambulatory Family Planning Facility
  • Rochester, NY
  • NPI 1306909957

  Women'S Health

  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1609965565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "address_2": "USA MEDDAC",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025004",
            "telephone_number": "315-785-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "002171",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "420663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03400828",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanne Yeagle, P.A.
• Dustin Young, PHYSICIAN ASSISTANT
• Stephen Michael Young, M.D.
• Emory James Yuhasz, B.S.
• Liana Zacharias, R.D., L.D

• Women's Health Nurse Practitioner in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Women's Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.