Individual provider Active NPI

Elizabeth Blair Jenks, FNP-BC

  • Family Nurse Practitioner
  • North Babylon, NY
National Provider Identifier
1619748514
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
353279 Issued in NY
Practice address
1486 Deer Park Ave Unit a
North Babylon, NY 11703-1214
Phone
(631) 425-3811
Fax
(929) 455-9839
NPI assigned
Jan 10, 2024
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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 353279 NY Primary

Addresses

Primary practice location

1486 Deer Park Ave Unit a
North Babylon, NY 11703-1214

Mailing address

1486 Deer Park Ave Unit a
North Babylon, NY 11703-1214
Phone (631) 425-3811

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
I20240605001733 NY Practitioner - Nurse Practitioner 1658813613 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 29, 2024 Accepting new patients
New York University CurrentSince Apr 29, 2024 Accepting new patients

Locations

1486 Deer Park Ave
Unit A
North Babylon, NY 11703
Phone (631) 422-3200

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: eblair493018@nyumc.direct-ci.com

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, 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": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1619748514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1486 DEER PARK AVE UNIT A",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117031214",
            "telephone_number": "631-425-3811",
            "fax_number": "929-455-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486 DEER PARK AVE UNIT A",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117031214",
            "telephone_number": "631-425-3811",
            "fax_number": "929-455-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKS",
        "first_name": "ELIZABETH",
        "middle_name": "BLAIR",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-10",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

Verify at the official NPI Registry.