Individual provider Active NPI

Nenita Jusayan, MD

  • Internal Medicine Physician
  • Sunnyside, NY
National Provider Identifier
1720093156
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
222955 Issued in NY
Practice address
4121 Greenpoint Ave
Sunnyside, NY 11104
Phone
(718) 937-2055
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 222955 NY Primary

Addresses

Primary practice location

4121 Greenpoint Ave
Sunnyside, NY 11104

Mailing address

4121 Greenpoint Ave
Sunnyside, NY 11104-3007
Phone (718) 937-2055

Other identifiers 1

IdentifierTypeStateIssuer
222955OtherNYSTATE LICENSE

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
222955NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Startcare, Inc. Past Accepting new patients
Munoz Regimbal and Associates Physicians Professional LLC Past Accepting new patients
Healthcare First Medical, P.C. Internal Medicine Past Accepting new patients
Caduceus Medical Care LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720093156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 GREENPOINT AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111043007",
            "telephone_number": "718-937-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 GREENPOINT AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "11104",
            "telephone_number": "718-937-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSAYAN",
        "first_name": "NENITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "222955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "222955",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.