Individual provider Active NPI

Jessica Ann Riepe, P.A.

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1760667323
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009143-1 Issued in NY
Practice address
1366 Victory Blvd
Staten Island, NY 10301-3907
Phone
(718) 944-2835
Fax
(718) 442-4073
NPI assigned
Jan 2, 2008
Last updated
Dec 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009143-1 NY Primary

Addresses

Primary practice location

1366 Victory Blvd
Staten Island, NY 10301-3907

Mailing address

1366 Victory Blvd
Staten Island, NY 10301-3907
Phone (718) 442-8351

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
I20040506001445 NY Practitioner - Physician Assistant 8921097809 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

1950 Jericho Tpke
East Northport, NY 11731-6207
Phone (631) 238-3065

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

5145 Nesconset Hwy
Suite 4
Port Jefferson Station, NY 11776-2118
Phone (347) 493-2945

527 Boulevard E
Yaphank, NY 11980-7512
Phone (631) 504-0427

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009143-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jan 16, 2019 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Oct 16, 2025 Accepting new patients
Samala R Swamy, MD, PC PastSince Nov 4, 2009 Accepting new patients
Zahir H Rahman MD PLLC PastSince Nov 1, 2021 Accepting new patients
Emergency Medicine Physicians of Suffolk County, PLLC Past Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

300 Community Dr
Manhasset, NY 11030

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: jessica.riepe@ghuc.eclinicaldirectplus.com
  • Direct secure messaging: jriepe69459@northwell.direct-ci.com

Organizations & group practices 7

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": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1760667323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013907",
            "telephone_number": "718-442-8351",
            "fax_number": "718-442-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013907",
            "telephone_number": "718-944-2835",
            "fax_number": "718-442-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEPE",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009143-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.