Individual provider Active NPI

Jordan Thomas Beyar, FNP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1891236402
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F3414081 Issued in NY
Practice address
2177 Victory Blvd
Staten Island, NY 10314-6603
Phone
(718) 370-3730
Fax
(718) 605-8257
NPI assigned
Mar 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F3414081 NY Primary

Addresses

Primary practice location

2177 Victory Blvd
Staten Island, NY 10314-6603

Mailing address

42 Lakeland Rd
Staten Island, NY 10314-2506
Phone (718) 644-8996

Other practice location 1

4143 Richmond Ave Ste 2
Staten Island, NY 10312-5637
Phone (718) 966-5556

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
I20171004003216 NY Practitioner - Nurse Practitioner 0143595983 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F3414081NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frank Scafuri III D.O.P,C CurrentSince Dec 4, 2017 Accepting new patients
Memorial Anesthesiology Group CurrentSince Aug 2, 2017 Accepting new patients
Pretam G Rampersaud MD PC Past Accepting new patients

Locations

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

2177 Victory Blvd
Staten Island, NY 10314
Phone (718) 370-3730

3453 Richmond Ave
Ste 200
Staten Island, NY 10312
Phone (718) 605-4700

4143 Richmond Ave
Ste 2
Staten Island, NY 10312
Phone (718) 966-5556

682 Forest Ave
Staten Island, NY 10310
Phone (718) 370-3730

Networks

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

Interoperability endpoints

  • Direct secure messaging: jbeyar22783@mskcc.direct-ci.com

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": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1891236402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 LAKELAND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142506",
            "telephone_number": "718-644-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146603",
            "telephone_number": "718-370-3730",
            "fax_number": "718-605-8257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4143 Richmond Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103125637",
            "country_code": "US",
            "telephone_number": "718-966-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEYAR",
        "first_name": "JORDAN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F3414081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.