Individual provider Active NPI

Jennifer Macqueen, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1659595692
Registry record updated Apr 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
400660 Issued in NY
Practice address
245 5TH Ave
New York, NY 10016-8728
Phone
(855) 444-7258
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95020704 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 400660 NY Primary

Addresses

Primary practice location

245 5TH Ave
New York, NY 10016-8728

Mailing address

2197 Western Ave
Arcata, CA 95521-5349
Phone (917) 415-1953

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
I20090805000483 NY Practitioner - Nurse Practitioner 2163575325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatric Nurse Practitioner PCGroup PAC ID 6901221795, 45 clinicians

Practice addresses (Care Compare)

191 Orchard St
Apt 4D
New York, NY 10002-1424
Phone (718) 534-0689

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Apr 1, 2021 Accepting new patients
Psychiatric Nurse Practitioner P.C Psychiatric/Mental Health CurrentSince Apr 25, 2024 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Apr 1, 2021 Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

105 Marys Ave
Kingston, NY 12401
Phone (845) 334-3080

396 Broadway
Kingston, NY 12401
Phone (845) 331-3131

245 5th Ave
Fl 3
New York, NY 10016
Phone (212) 302-4399

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Organizations & group practices 3

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712361600000",
    "number": "1659595692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2197 WESTERN AVE",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215349",
            "telephone_number": "917-415-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168728",
            "telephone_number": "855-444-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACQUEEN",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020704",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "400660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.