Individual provider Active NPI

Karolyn Zulema Rosa de Jesus, FNP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1780396259
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350968 Issued in NY
Practice address
2721 Bronxwood Ave
Bronx, NY 10469-3642
Phone
(347) 736-0207
Fax
(347) 736-0207
NPI assigned
Dec 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 350968 NY Primary

Addresses

Primary practice location

2721 Bronxwood Ave
Bronx, NY 10469-3642

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

Other practice location 1

1953 University Ave
Bronx, NY 10453-4404
Phone (718) 765-6054

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Laptop_Smartphones Health Information Exchange (HIE)

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
I20230505000426 NY Practitioner - Nurse Practitioner 8820453376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Myers Medical PCGroup PAC ID 5294145017, 78 clinicians

Practice addresses (Care Compare)

11515 Sutphin Blvd
Jamaica, NY 11434-1020
Phone (718) 765-6009

2721 Bronxwood Ave
Bronx, NY 10469-3642
Phone (718) 765-6350

455 Sutter Ave
Brooklyn, NY 11212-8111
Phone (718) 765-6550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
350968NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Griffin Myers Medical, P.C. Family CurrentSince Feb 6, 2023 Accepting new patients

Locations

1953 Dr Martin L King Jr Blvd
Bronx, NY 10453

2721 Bronxwood Ave
Bronx, NY 10469
Phone (347) 736-0207

455 Sutter Ave
Brooklyn, NY 11212
Phone (718) 765-6550

11515 Sutphin Blvd
Jamaica, NY 11434
Phone (718) 659-4000

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1780396259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 BRONXWOOD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693642",
            "telephone_number": "347-736-0207",
            "fax_number": "347-736-0207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1953 University Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104534404",
            "country_code": "US",
            "telephone_number": "718-765-6054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSA DE JESUS",
        "first_name": "KAROLYN",
        "middle_name": "ZULEMA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop_Smartphones",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1370 Saint Nicholas Ave Apt 27N",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100336233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.