Individual provider Active NPI

Marie B Jusay, AGNP-C

  • Adult Health Nurse Practitioner
  • Mount Kisco, NY
National Provider Identifier
1750159430
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F311453 Issued in NY
Practice address
400 E Main St
Mount Kisco, NY 10549-3417
Phone
(914) 666-1200
NPI assigned
Dec 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F311453 NY Primary

Addresses

Primary practice location

400 E Main St
Mount Kisco, NY 10549-3417

Mailing address

400 E Main St
Mount Kisco, NY 10549-3477

Other names 1

  • Marie Bagaforo Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240507001293 NY Practitioner - Nurse Practitioner 1254771348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

Hospital & facility affiliations

  • Northern Westchester Hospital Hospital, Mount Kisco, NY, CCN 330162
  • Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F311453NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 31, 2024 Accepting new patients

Locations

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: mjusay61105@northwell.direct-ci.com
  • Direct secure messaging: mariejusay@nslijmedgr.allscriptsdirect.net

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1750159430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSAY",
        "first_name": "MARIE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2024-04-10",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "BAGAFORO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.