NPIMap

Individual provider Active NPI

Bita Jalilizeinali, NP

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1710006275
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F303445 Issued in NY
Practice address
520 E 70TH St
St-3
New York, NY 10021-9800
Phone
(212) 746-2650
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F303445 NY Primary
Adult Health Nurse Practitioner 363LA2200X 303445 NY

Addresses

Primary practice location

520 E 70TH St
St-3
New York, NY 10021-9800

Mailing address

101 Nicolls Road
HSC 18, Room 030, Z-8183
Stony Brook, NY 11794
Phone (631) 444-3577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230502000644 NY Practitioner - Nurse Practitioner 1153786892 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
Stony Brook Internists University Faculty Practice CorporationGroup PAC ID 9133019821, shared by 4 NPIs, 427 clinicians

Practice addresses (Care Compare)

3 Edmond D Pellegrino Rd
Stony Brook, NY 11794-9447
Phone (631) 638-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F303445NYMDNurse Practitioner
303445NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Apr 3, 2023 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Apr 3, 2023 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Apr 3, 2023 Accepting new patients

Locations

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794
Phone (631) 638-0800

101 Nicolls Rd
Rm 30
Stony Brook, NY 11794
Phone (631) 444-2292

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: bita.jalilizeinali@direct.stonybrookmedicine.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1710006275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS ROAD",
            "address_2": "HSC 18, ROOM 030, Z-8183",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-3577",
            "fax_number": "631-444-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 70TH ST",
            "address_2": "ST-3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100219800",
            "telephone_number": "212-746-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALILIZEINALI",
        "first_name": "BITA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F303445",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303445",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.