Individual provider Active NPI

Jennifer L. Giordano

  • Family Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1730557893
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342175 Issued in NY
Practice address
215 Hallock Rd Ste 3D
Stony Brook, NY 11790-3077
Phone
(631) 675-9777
Fax
(631) 675-9778
NPI assigned
Sep 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 469046-1 NY
Lactation Consultant (Registered Nurse) 163WL0100X 469046-1 NY
Family Nurse Practitioner 363LF0000X 342175 NY Primary

Addresses

Primary practice location

215 Hallock Rd Ste 3D
Stony Brook, NY 11790-3077

Mailing address

29 Penelope Dr
Setauket, NY 11733-2009
Phone (631) 255-8234

Other practice location 1

207 Hallock Rd Ste 106
Stony Brook, NY 11790-3075
Phone (631) 675-9777

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
469046-1NYMDRegistered Nurse
342175NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Latch With Love, Inc Family CurrentSince Apr 13, 2025 Accepting new patients
Jason Halegoua, M.D., P.C. PastSince Mar 24, 2024 Accepting new patients

Locations

215 Hallock Rd
Ste 3D
Stony Brook, NY 11790
Phone (631) 255-8234

Organizations & group practices 2

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": "1441584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1730557893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 PENELOPE DR",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332009",
            "telephone_number": "631-255-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HALLOCK RD STE 3D",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903077",
            "telephone_number": "631-675-9777",
            "fax_number": "631-675-9778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Hallock Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117903075",
            "country_code": "US",
            "telephone_number": "631-675-9777",
            "fax_number": "631-675-9778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIORDANO",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-07",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "469046-1",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "469046-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.