Jessica Marie Magioncalda, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

405989 Issued in NY

Practice address

100 Granny Rd Ste 1
Farmingville, NY 11738-2879

Phone

(631) 696-4957

NPI assigned

Aug 6, 2024

Last updated

Aug 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

City University of New York School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

CS Medical Associates, PCGroup PAC ID 9335401454, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• CS Medical Associates, P.C.

  dba Victory Recovery Partners

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Farmingville, NY
  • NPI 1992210231
  Medicare reassignment Care Compare group NPD
• CS Medical Associates, P.C.

  • Counselor
  • Amityville, NY
  • NPI 1790653236
  NPD
• CS Medical Associates, P.C.

  dba Victory Recovery Partners

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Riverhead, NY
  • NPI 1043873417
  NPD (past)

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1629808563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CIRCLE CT",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117382309",
            "telephone_number": "631-459-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRANNY RD STE 1",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117382879",
            "telephone_number": "631-696-4957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGIONCALDA",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Lotierzo, LPN
• Ruth Love, LMSW, MSCCC
• Harold B Luke, M.D.
• Ian C Lyons, LMSW
• Vanessa Lyte
• Andrew Magnano, ANDREW MAGNANO
• Marissa Manfredi
• Eric Mangles
• Sherene Mangles
• Elizabeth Marx, RPH

• Psychiatric/Mental Health Nurse Practitioner in Farmingville, NY
• Providers in Farmingville, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.