Individual provider Active NPI

Jenet Dipak Sisodia

  • School Registered Nurse
  • Staten Island, NY
National Provider Identifier
1689578742
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
74251201 Issued in NY
Practice address
262 Harbor Rd
Staten Island, NY 10303-1817
Phone
(347) 909-6022
NPI assigned
Oct 5, 2026
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 74251201 NY Primary

Addresses

Primary practice location

262 Harbor Rd
Staten Island, NY 10303-1817

Mailing address

262 Harbor Rd
Staten Island, NY 10303-1817
Phone (347) 951-4694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1689578742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 HARBOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031817",
            "telephone_number": "347-951-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 HARBOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031817",
            "telephone_number": "347-909-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISODIA",
        "first_name": "JENET",
        "middle_name": "DIPAK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-05",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "74251201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.