Individual provider Active NPI

Jessica Widmer, D.O.

  • Gastroenterology Physician
  • Mineola, NY
National Provider Identifier
1902115363
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
259448 Issued in NY
Practice address
276 1St St Apt 1K
Mineola, NY 11501-2366
Phone
(516) 750-5851
NPI assigned
Oct 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 259448 NY Primary
Internal Medicine Physician 207R00000X 259448-1 NY

Addresses

Primary practice location

276 1St St Apt 1K
Mineola, NY 11501-2366

Mailing address

276 1St St Apt 1K
Mineola, NY 11501-2366
Phone (516) 750-5851

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwidmer230645@nyumc.direct-ci.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120705000155 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 0840455416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
259448-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
New York University Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients

Locations

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

1111 Franklin Ave
Garden City, NY 11530
Phone (516) 222-8600

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

222 Station Plz N
Ste 428
Mineola, NY 11501
Phone (516) 663-2066

222 Station Plz N
Mineola, NY 11501
Phone (516) 663-1111

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: jwidmer230645@nyumc.direct-ci.com

Organizations & group practices 2

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 7

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": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1902115363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 1ST ST APT 1K",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012366",
            "telephone_number": "516-750-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 1ST ST APT 1K",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012366",
            "telephone_number": "516-750-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMER",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "259448",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "259448-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwidmer230645@nyumc.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "222 Station Plz N",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.