Active NPI
Jeremy Val Jovellanos, MD
- Pediatrics Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 318038
- Practice address
- 1000 10TH Ave
New York, NY 10019-1147 - Phone
- (212) 523-4000
- NPI assigned
- Apr 12, 2019
- Last updated
- Dec 6, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Pediatrics Physician | 208000000X | 318038 | NY | Primary |
Addresses
Primary practice location
1000 10TH Ave
New York, NY 10019-1147
Mailing address
175 E 96TH St Apt 30L
New York, NY 10128-6215
Phone (917) 301-4683
Other practice location 1
100 E 77th St
New York, NY 10075-1850
Phone (212) 434-2136
Other practice location 2
4500 Parsons Blvd
Flushing, NY 11355-2205
Phone (718) 670-5000
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| North Shore - Lij Medical PC | Current | Accepting new patients | |
| St Lukes Roosevelt Hospital Center | Past | Accepting new patients | |
| Lenox Hill Hospital | Past | Accepting new patients |
Locations
4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631
300 Community Dr
Manhasset, NY 11030
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
100 E 77th St
New York, NY 10075
Phone (212) 434-2606
1000 10th Ave
New York, NY 10019
Phone (212) 523-2369
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- jjovellanos66747@northwell.direct-ci.com
Organizations & group practices 4
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.
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
dba NSLIJ Medical In Queens
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
-
- General Acute Care Hospital
- New York, NY
- NPI 1477616571
-
- General Acute Care Hospital
- New York, NY
- NPI 1104982917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1639632953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 E 96TH ST APT 30L",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101286215",
"telephone_number": "917-301-4683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 10TH AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100191147",
"telephone_number": "212-523-4000"
}
],
"practiceLocations": [
{
"address_1": "100 E 77th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100751850",
"country_code": "US",
"telephone_number": "212-434-2136",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4500 Parsons Blvd",
"address_purpose": "LOCATION",
"city": "Flushing",
"state": "NY",
"postal_code": "113552205",
"country_code": "US",
"telephone_number": "718-670-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOVELLANOS",
"first_name": "JEREMY",
"middle_name": "VAL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-12",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "318038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.