Mariel Jensen, CPNP, DNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F382728-1 Issued in NY

Practice address

390 Montauk Hwy
West Islip, NY 11795-4403

Phone

(631) 422-0700

Fax

(631) 422-0703

NPI assigned

Jun 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1790135523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954403",
            "telephone_number": "631-422-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954403",
            "telephone_number": "631-422-0700",
            "fax_number": "631-422-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MARIEL",
        "credential": "CPNP, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382728-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sulaiman Jamal Asmatullah, MD
• Meghan James, PA-C
• Reine James
• Fozia Jangda, M.D.
• Kenney Justin Jean-Pierre, PA-C
• Theresa Jensen, PT
• Sang H Jho, MD
• Dona Treesa Jin, DO
• Joanne Lamonica MD PC
• John F. Gallagher, M.D., P.C.

• Pediatric Nurse Practitioner in West Islip, NY
• Providers in West Islip, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.