Individual provider Active NPI

Jennifer Karen Taylor, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Fishkill, NY
National Provider Identifier
1770074643
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F342729-1 Issued in NY
Practice address
600 Westage Business Ctr Dr
Fishkill, NY 12524-2281
Phone
(845) 592-7780
NPI assigned
May 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F342729-1 NY Primary

Addresses

Primary practice location

600 Westage Business Ctr Dr
Fishkill, NY 12524-2281

Mailing address

22 Pleasant LN
Poughkeepsie, NY 12603-5650
Phone (845) 592-7780

Other names 1

  • Jennifer Karen Gosselin 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
I20180705000311 NY Practitioner - Nurse Practitioner 6002162062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

30 Columbia St
Poughkeepsie, NY 12601-3906
Phone (845) 231-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F342729-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Jul 16, 2018 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jul 16, 2018 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

100 Independent Way
Ste H
Brewster, NY 10509
Phone (845) 279-2000

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

30 Columbia St
Poughkeepsie, NY 12601
Phone (845) 483-5934

Philadelphia, PA 19195

Networks

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

Interoperability endpoints

  • Direct secure messaging: jtaylor145168@direct.optum.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1770074643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PLEASANT LN",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126035650",
            "telephone_number": "845-592-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WESTAGE BUSINESS CTR DR",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125242281",
            "telephone_number": "845-592-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "middle_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342729-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GOSSELIN",
            "middle_name": "KAREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.