Active NPI
Jenee Brock
- Family Nurse Practitioner
- Bethpage, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 354940
- Practice address
- 4295 Hempstead Tpke
Bethpage, NY 11714-5713 - Phone
- (904) 372-3943
- Fax
- (904) 212-1618
- NPI assigned
- Aug 7, 2024
- Last updated
- Sep 30, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 354940 | NY | Primary |
| Emergency Registered Nurse | 163WE0003X | 747933 | NY | |
| Adult Medicine Physician | 207QA0505X | 354940 | NY |
Addresses
Primary practice location
4295 Hempstead Tpke
Bethpage, NY 11714-5713
Mailing address
7751 Belfort Pkwy Ste 120
Jacksonville, FL 32256-6921
Phone (904) 372-3943
Other practice location 1
327 Beach 19th St
Far Rockaway, NY 11691-4423
Phone (718) 869-7000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7751 Belfort Pkwy
Suite 120
Jacksonville, FL 32256-6921
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 747933 | NY | MD | Emergency Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diabetes Management Partners LLC | Current | Accepting new patients | |
| Diabetes Management Partners LLC | Current | Accepting new patients | |
| Midtown Medical Solutions PC | Past | Accepting new patients |
Locations
7751 Belfort Pkwy
Ste 120
Jacksonville, FL 32256
4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Bethpage, NY
- NPI 1013461193
-
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- Bel Air, MD
- NPI 1245101617
-
- Pain Medicine Physician
- New York, NY
- NPI 1013334234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759190400000",
"number": "1821828492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7751 BELFORT PKWY STE 120",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566921",
"telephone_number": "904-372-3943",
"fax_number": "904-212-1618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4295 HEMPSTEAD TPKE",
"city": "BETHPAGE",
"state": "NY",
"postal_code": "117145713",
"telephone_number": "904-372-3943",
"fax_number": "904-212-1618"
}
],
"practiceLocations": [
{
"address_1": "327 Beach 19th St",
"address_purpose": "LOCATION",
"city": "Far Rockaway",
"state": "NY",
"postal_code": "116914423",
"country_code": "US",
"telephone_number": "718-869-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROCK",
"first_name": "JENEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-07",
"last_updated": "2025-09-30",
"certification_date": "2025-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "354940",
"primary": true
},
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "NY",
"license": "747933",
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "NY",
"license": "354940",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethpage, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.