Jennilyn Scamardella, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F311784-01 Issued in NY

Practice address

1934 Waltoffer Ave
North Bellmore, NY 11710-1531

Phone

(516) 732-8243

NPI assigned

Aug 13, 2024

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

Other names 1

• Jennilyn Kobbe Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1841021664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 WALTOFFER AVE",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117101531",
            "telephone_number": "516-732-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 WALTOFFER AVE",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117101531",
            "telephone_number": "516-732-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAMARDELLA",
        "first_name": "JENNILYN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311784-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNILYN",
            "last_name": "KOBBE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Adult Health Nurse Practitioner in North Bellmore, NY
• Providers in North Bellmore, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.