Individual provider Active NPI

Jennifer Lincks, N.P.

  • Adult Health Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1750334025
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
247230 Issued in MA
Practice address
1991 Marcus Ave
2ND Floor
New Hyde Park, NY 11042
Phone
(516) 354-1600
Fax
(516) 941-4677
NPI assigned
May 18, 2006
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 247230 MA Primary

Addresses

Primary practice location

1991 Marcus Ave
2ND Floor
New Hyde Park, NY 11042

Mailing address

55 Water Street
2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

1991 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 354-1600

Other practice location 2

1991 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 354-1600

Other practice location 3

350 South Broadway
Hicksville, NY 11801-5006
Phone (516) 938-0100

Other names 1

  • Jennifer Johnson Former name

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PRN Physical Therapy PC CurrentSince Sep 25, 2019 Accepting new patients
Qlimg Lake Success/New Hyde Park Med. Office PastSince Sep 25, 2019 Accepting new patients

Locations

350 S Broadway
Hicksville, NY 11801
Phone (516) 733-8085

1991 Marcus Ave
#2
North New Hyde Park, NY 11042
Phone (516) 354-1600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1750334025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER STREET",
            "address_2": "2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-354-1600",
            "fax_number": "516-941-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Marcus Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "11042",
            "country_code": "US",
            "telephone_number": "516-354-1600",
            "fax_number": "516-941-4677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1991 Marcus Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "11042",
            "country_code": "US",
            "telephone_number": "516-354-1600",
            "fax_number": "516-941-4677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 South Broadway",
            "address_purpose": "LOCATION",
            "city": "Hicksville",
            "state": "NY",
            "postal_code": "118015006",
            "country_code": "US",
            "telephone_number": "516-938-0100",
            "fax_number": "516-938-0120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINCKS",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "247230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.