Individual provider Active NPI

Jennifer M Kurulgan, AGNP-C

  • Adult Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1861920514
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307967-1 Issued in NY
Practice address
2260 Victory Blvd
Staten Island, NY 10314-6622
NPI assigned
May 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F307967-1 NY Primary

Addresses

Primary practice location

2260 Victory Blvd
Staten Island, NY 10314-6622

Mailing address

2260 Victory Blvd
Staten Island, NY 10314-6622
Phone (718) 761-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, DE, VA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20171222000491 NY Practitioner - Nurse Practitioner 7719245679
I20220728003397 NJ Practitioner - Nurse Practitioner 7719245679 Reassigns benefits to 1 organization
I20240513001142 DE Practitioner - Nurse Practitioner 7719245679 Reassigns benefits to 1 organization
I20240522001828 VA Practitioner - Nurse Practitioner 7719245679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F307967-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Visavis Health Care Medical Group of de PA CurrentSince Apr 8, 2024 Accepting new patients
Visavis Health Care Medical Group of NJ LLC CurrentSince Apr 19, 2022 Accepting new patients
Visavis Health Care Medical Group of VA LLC CurrentSince Apr 8, 2024 Accepting new patients

Locations

715 E King St
Seaford, DE 19973
Phone (302) 536-5628

1481 McDonald Ave
Fl 2
Brooklyn, NY 11230

831 Bedford Ave
Brooklyn, NY 11205

7300 State Highway 121
Ste 300374
McKinney, TX 75070

11 Dairy Ln
Fredericksburg, VA 22405
Phone (540) 371-9414

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1861920514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146622",
            "telephone_number": "718-761-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURULGAN",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307967-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.