Jennifer Lynn Klingenberger-Beyer, M.D.
Individual provider Active NPI Pediatrics Physician · East Moriches, NY
NPI 1740595461 · NPPES record last updated Apr 21, 2015
Key facts
- NPI
- 1740595461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 266749 (NY)
- Practice address
- 492 Montauk Hwy
East Moriches, NY 11940-1347 - Phone
- (631) 638-2901
- NPI assigned
- Aug 18, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130830000102 | NY | Practitioner - Pediatric Medicine | 8527201151 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 266749 | NY | MD | Pediatrics Physician |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Children'S Service, University Faculty Practice Corporatio | Pediatrics | Current |
Accepting new patients |
| University Hospital at Stony Brook | Current | Accepting new patients |
Locations
600 Montauk Hwy
Ste A
Center Moriches, NY 11934
Phone (631) 638-2900
492 Montauk Hwy
East Moriches, NY 11940
Phone (631) 638-2900
2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- jenn.klingenberger-beyer@direct.stonybrookmedicine.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 266749 | NY | Yes |
Addresses
Primary practice location
492 Montauk Hwy
East Moriches, NY 11940-1347
Mailing address
PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-0650
Other providers in East Moriches, NY
- Priscilla Karpin
- Megan Kasnicki
- Berna Kayas
- Eileen Kelly
- Rebecca A Kincade
- Lisa Kominos
- Stacy Ann Krey
- Melanie Kuklis
- Carly Lawrence
- Irene Logan
All providers in East Moriches, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.