Individual provider Active NPI

Jessica De Leon, NP

  • Primary Care Nurse Practitioner
  • Elmhurst, NY
National Provider Identifier
1881390482
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
311125 Issued in NY
Practice address
7901 Broadway # A1-19
Elmhurst, NY 11373-1329
Phone
(718) 334-5741
Fax
(718) 334-5006
NPI assigned
Feb 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311125 NY
Primary Care Nurse Practitioner 363LP2300X 311125 NY Primary

Addresses

Primary practice location

7901 Broadway # A1-19
Elmhurst, NY 11373-1329

Mailing address

7901 Broadway # A1-19
Elmhurst, NY 11373-1329
Phone (718) 334-5741

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
I20240304001058 NY Practitioner - Nurse Practitioner 4082059795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York City Health and Hospitals CorporationGroup PAC ID 4183535305, 543 clinicians

Practice addresses (Care Compare)

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-4000

Hospital & facility affiliations

  • Elmhurst Hospital Center Hospital, Elmhurst, NY, CCN 330128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311125NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Jan 6, 2024 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jan 6, 2024 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

Networks

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

Organizations & group practices 4

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 1

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": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1881390482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY # A1-19",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-5741",
            "fax_number": "718-334-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY # A1-19",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-5741",
            "fax_number": "718-334-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311125",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "311125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.