Jay Kyle Zimmerman, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

346885 Issued in NY

Practice address

231 Granite Run Dr
Lancaster, PA 17601-6823

Phone

(717) 560-4200

Fax

(717) 560-4159

NPI assigned

Nov 8, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jericho Road Ministries, Inc.Group PAC ID 5597992933, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jay.zimmerman@jrchc.medentdirect.com

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.

• Jericho Road Ministries Inc.

  • Federally Qualified Health Center (FQHC)
  • Buffalo, NY
  • NPI 1972944080
  Medicare reassignment Care Compare group NPD
• Jericho Road Ministries Inc.

  • Federally Qualified Health Center (FQHC)
  • Buffalo, NY
  • NPI 1215502711
  NPD
• Lancaster Orthopedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Mount Joy, PA
  • NPI 1518118538
  NPD (past)

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1881107225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BROADWAY ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121460",
            "telephone_number": "716-529-3020",
            "fax_number": "716-529-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 GRANITE RUN DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016823",
            "telephone_number": "717-560-4200",
            "fax_number": "717-560-4159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142121460",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142121460",
            "country_code": "US",
            "telephone_number": "716-529-3020",
            "fax_number": "716-529-3040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142121460",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142121460",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142121460",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142121460",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142121460",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JAY",
        "middle_name": "KYLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-08",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346885",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP018058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris Pauline Zimmerman, MSN RN CNS-BC LMFT
• Eric L Zimmerman, PA-C
• Harmony K Zimmerman, MD
• Jacqui L Zimmerman, RD, LDN
• Janelle Alynn Zimmerman, COTA/L
• Jennifer Lynn Zimmerman, CRNP
• Mark David Zimmerman, M.D.
• Samantha Leigh Zimmerman, PA-C
• Alexis Zink
• Angela M Zinkan, MS SLP

• Family Nurse Practitioner in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.