NPIMap

Individual provider Active NPI

Jaylyn Fuentes, PA-C

  • Physician Assistant
  • White Plains, NY
National Provider Identifier
1851031512
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029165 Issued in NY
Practice address
122 Maple Ave FL 8
White Plains, NY 10601-4706
Phone
(914) 849-7897
Fax
(914) 337-3710
NPI assigned
Mar 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 029165 NY Primary

Addresses

Primary practice location

122 Maple Ave FL 8
White Plains, NY 10601-4706

Mailing address

1 Allen St
Valhalla, NY 10595-1429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230330002164 NY Practitioner - Physician Assistant 1951776145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White Plains Physician Services PCGroup PAC ID 3476894445, 386 clinicians

Practice addresses (Care Compare)

122 Maple Ave
White Plains, NY 10601-4706
Phone (914) 285-9808

185 Kisco Ave
Suite 300
Mount Kisco, NY 10549-1409
Phone (914) 242-2020

41 E Post Rd
White Plains, NY 10601-4607
Phone (914) 681-0600

750 White Plains Rd
Scarsdale, NY 10583-5002
Phone (914) 849-4300

Hospital & facility affiliations

  • White Plains Hospital Center Hospital, White Plains, NY, CCN 330304
  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270
  • Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
029165NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Physician Services PC CurrentSince Mar 28, 2023 Accepting new patients

Locations

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

41 E Post Rd
#4I
White Plains, NY 10601
Phone (914) 981-2655

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

122 Maple Ave
Fl 8
White Plains, NY 10601
Phone (914) 849-5300

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1851031512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ALLEN ST",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 MAPLE AVE FL 8",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014706",
            "telephone_number": "914-849-7897",
            "fax_number": "914-337-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "JAYLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.