Shannon Patricia More Jarzynka, DNP, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

382361 Issued in NY

Practice address

1400 Pelham Pkwy S
Bronx, NY 10461-1138

Phone

(718) 918-5875

NPI assigned

Sep 29, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: shannon.jarzynka.1@24265.direct.athenahealth.com
• Direct secure messaging: spm7004@direct.nyp.org

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.

• Fpa Hospital Based

  • Nuclear Medicine Physician
  • New York, NY
  • NPI 1629319413
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Rehabilitation Practitioner
  • New York, NY
  • NPI 1477899078
  Medicare reassignment NPD
• Kings Physician Services, PC

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1083045090
  Medicare reassignment NPD
• Fpa Hospital Based

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1427398676
  NPD
• Fpa Hospital Based

  • Dermatopathology (Pathology) Physician
  • New York, NY
  • NPI 1841531795
  NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Kings Physician Services, PC

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1326698879
  NPD
• Boston Pediatrics, PLLC

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1275724767
  NPD (past)
• Icahn School of Medicine at Mount Sinai

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1124392212
  NPD (past)

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

{
    "created_epoch": "1348876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1730430786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W 78TH ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246665",
            "telephone_number": "908-399-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138",
            "telephone_number": "718-918-5875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1262 Boston Rd",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104563602",
            "country_code": "US",
            "telephone_number": "718-617-2500 x1032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARZYNKA",
        "first_name": "SHANNON",
        "middle_name": "PATRICIA MORE",
        "name_prefix": "Ms.",
        "credential": "DNP, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-29",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "644299",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Spm7004@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Glenda Karen Jarvis
• Hannah Claire Jarvis, MBBS BSC (HONS) MRCS
• Jonique Jarvis
• Omar Jarvis
• Cassandra Jarzyna
• Jas Pharmacy Inc.
• Frantz Jasmin, M.D.
• Johanne Jasmin, FNP
• Jason R. Gordon D.D.S. P. C.
• Nancy Ann Roberson Jasper, M.D.

• Pediatric Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.