Individual provider Active NPI

Jaime Quintanilla

  • Psychiatry Physician
  • Westbury, NY
National Provider Identifier
1902474562
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
339713 Issued in NY
Practice address
1400 Old Country Rd Ste 103N
Westbury, NY 11590-5119
Phone
(833) 350-8255
NPI assigned
Jun 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 339713 NY Primary

Addresses

Primary practice location

1400 Old Country Rd Ste 103N
Westbury, NY 11590-5119

Mailing address

1400 Old Country Rd Ste 103N
Westbury, NY 11590-5119

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
I20260219000356 NY Practitioner - Psychiatry 0840770657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sr Medical Services PLLCGroup PAC ID 2668832379, 11 clinicians

Practice addresses (Care Compare)

1400 Old Country Rd
Suite 200a
Westbury, NY 11590-5112
Phone (833) 350-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339713NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sr Medical Services PLLC Psychiatry CurrentSince Jan 26, 2026 Accepting new patients

Locations

1400 Old Country Rd
Ste 200A
Westbury, NY 11590
Phone (833) 350-8255

1400 Old Country Rd
Ste 103N
Westbury, NY 11590
Phone (516) 346-5268

1400 Old Country Rd
Ste 103
Westbury, NY 11590

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": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1902474562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 OLD COUNTRY RD STE 103N",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 OLD COUNTRY RD STE 103N",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905119",
            "telephone_number": "833-350-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANILLA",
        "first_name": "JAIME",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "339713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbury, NY

Sources for this page

Verify at the official NPI Registry.