Individual provider Active NPI

Jenee Brock

  • Family Nurse Practitioner
  • Bethpage, NY
National Provider Identifier
1821828492
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354940 Issued in NY
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, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251008003589 NY Practitioner - Nurse Practitioner 3678070380 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
747933NYMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes Management Partners LLC CurrentSince Nov 1, 2025 Accepting new patients
Diabetes Management Partners LLC CurrentSince Nov 1, 2025 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.

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

Verify at the official NPI Registry.