Active NPI
Jennifer L. Giordano
- Family Nurse Practitioner
- Stony Brook, NY
National Provider Identifier
1730557893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 342175
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 469046-1 | NY | MD | Registered Nurse |
| 342175 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Latch With Love, Inc | Family | Current | Accepting new patients |
| Jason Halegoua, M.D., P.C. | Past | 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.
-
- Family Nurse Practitioner
- Stony Brook, NY
- NPI 1629863535
-
- Pediatrics Physician
- Stony Brook, NY
- NPI 1750619581
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.