Jenna Marie Candemeres, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

383487 Issued in NY

Practice address

112 Terryville Rd
Port Jefferson Station, NY 11776-1329

Phone

(631) 209-2827

NPI assigned

Feb 21, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: jduggan77873@direct-chsli.net

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.

• Samaritan Pediatric Services, P.C.

  • Pediatrics Physician
  • Babylon, NY
  • NPI 1730308925
  Medicare reassignment NPD

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1932965688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 FERRARO DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 TERRYVILLE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761329",
            "telephone_number": "631-209-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDEMERES",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Calamia, LAC
• Lindsey Michelle Callan
• Michaela Cameron, MS
• Dolores L. Campbell, M.S.
• Patricia Campisi, PHARMD
• Andrea Lynn Cangiano, LCSW
• Catherine Caputo Caputo
• Erin Caraher, RD
• Careheart Cardiology PC
• Bridget Marian Carey, M.S. CCC-SLP

• Pediatric Nurse Practitioner in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.