Jacqueline Marjorie Lichtenstein, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

019016 Issued in NY

Practice address

340 Howells Rd Ste 2B
Bay Shore, NY 11706-5322

Phone

(833) 547-7463

Fax

(631) 318-9830

NPI assigned

Mar 15, 2010

Last updated

Oct 4, 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

Physician Assistant

Education

State University of New York at Stony Brook, School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amit Sharma MD PCGroup PAC ID 0244666915, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jacquelinelichtenstein@nslijmedgr.allscriptsdirect.net

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.

• Amit Sharma MD PC

  dba Interventional SpineCare

  • Interventional Pain Medicine Physician
  • Bay Shore, NY
  • NPI 1669014197
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1679897060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MOTOR PARKWAY",
            "address_2": "SUITE LL8",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11788",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HOWELLS RD STE 2B",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065322",
            "telephone_number": "833-547-7463",
            "fax_number": "631-318-9830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "182 Main St",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "NY",
            "postal_code": "117436987",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-318-9830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4250 Hempstead Tpke Ste 4",
            "address_purpose": "LOCATION",
            "city": "Bethpage",
            "state": "NY",
            "postal_code": "117145707",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-318-9830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 Commack Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117253405",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-318-9830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHTENSTEIN",
        "first_name": "JACQUELINE",
        "middle_name": "MARJORIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "019016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.