Jennifer Owensby

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

25MA06519800 Issued in NJ

Practice address

4802 10TH Ave
Brooklyn, NY 11219-2844

Phone

(718) 283-8894

Fax

(718) 635-7235

NPI assigned

Sep 14, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Rutgers Health-RWJ Pediatric Critical Care

  • Family Medicine Physician
  • New Brunswick, NJ
  • NPI 1780766527
  Medicare reassignment NPD
• Rutgers Health-RWJ Pediatric Critical Care

  • Pediatric Critical Care Medicine Physician
  • New Brunswick, NJ
  • NPI 1164510400
  NPD
• MMC Pediatrics Faculty Practice

  • Pediatrics Physician
  • Brooklyn, NY
  • NPI 1285648154
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1942295076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192844",
            "telephone_number": "718-283-8894",
            "fax_number": "718-635-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENSBY",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06519800",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "213965",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA06519800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02285165",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0100712-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFFINITY HEALTH",
            "identifier": "1000030187",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "135460101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "40N0391",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "4C4667",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2246605",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "8Q2301",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST",
            "identifier": "213965-A15",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Ray Owens Jr., MD
• Mark Corey Owens, RN
• Mark Steven Owens, DO
• Mary Rayven Owens, PHD
• Nina R Owens
• Owglct LLC
• Owl Early Intervention Program, LLC.
• Yetunde Owoaje
• Ayobami Gbemiga Owoeye
• Oyewale Ola Owolodun, LPN

• Pediatric Critical Care Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatric Critical Care Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.