Individual provider Active NPI

Jenny Thalappillil, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1699074690
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336566-1 Issued in NY
Practice address
2711 Mermaid Ave
Brooklyn, NY 11224-2005
Phone
(718) 758-5952
NPI assigned
Mar 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336566-1 NY Primary

Addresses

Primary practice location

2711 Mermaid Ave
Brooklyn, NY 11224-2005

Mailing address

2711 Mermaid Ave
Brooklyn, NY 11224-2005
Phone (718) 758-5952

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
I20151103001028 NY Practitioner - Nurse Practitioner 2668782632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

503 S Broadway
Suite 210
Yonkers, NY 10705-6202
Phone (914) 965-9771

Hospital & facility affiliations

  • Prime Home Health Services, LLC Home health agency, Brooklyn, NY, CCN 337190
  • St John'S Riverside Hospital Hospital, Yonkers, NY, CCN 330208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
336566NYMDLicensed Practical Nurse
F336566-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

Networks

  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1699074690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242005",
            "telephone_number": "718-758-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242005",
            "telephone_number": "718-758-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THALAPPILLIL",
        "first_name": "JENNY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336566-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.