Individual provider Active NPI

Jessy Koshy Zachariah, NP

  • Adult Health Nurse Practitioner
  • Manhasset, NY
National Provider Identifier
1861991002
Registry record updated Feb 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308278 Issued in NY
Practice address
300 Community Dr
Manhasset, NY 11030-3816
Phone
(516) 562-0100
NPI assigned
Feb 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 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 308278 NY Primary

Addresses

Primary practice location

300 Community Dr
Manhasset, NY 11030-3816

Mailing address

29 Tottenham PL
New Hyde Park, NY 11040-3516
Phone (516) 214-4924

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
I20200805000878 NY Practitioner - Nurse Practitioner 7517382799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

600 Northern Boulevard
Suite 111
Great Neck, NY 11021-5200
Phone (516) 562-4281

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

600 Northern Blvd
Ste 111
Great Neck, NY 11021
Phone (516) 387-3990

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

106 Charles Lindbergh Blvd
Ste B
Uniondale, NY 11553
Phone (516) 248-3737

Networks

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

Organizations & group practices 1

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1861991002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 TOTTENHAM PL",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403516",
            "telephone_number": "516-214-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAH",
        "first_name": "JESSY",
        "middle_name": "KOSHY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.