Individual provider Active NPI

Jessica N Lancen-Wahby, D.O.

  • Pediatrics Physician
  • Hempstead, NY
National Provider Identifier
1942558010
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
278847 Issued in NY
Practice address
175 Fulton Ave
#100
Hempstead, NY 11550-3718
Phone
(516) 292-1034
Fax
(516) 292-0565
NPI assigned
Aug 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 278847 NY Primary

Addresses

Primary practice location

175 Fulton Ave
#100
Hempstead, NY 11550-3718

Mailing address

222 Station PLZ N
Suite 611
Mineola, NY 11501-3800
Phone (516) 663-4938

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlancenwahby255388@nyumc.direct-ci.com

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
I20150929002250 NY Practitioner - Pediatric Medicine 7416265186 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
278847NYMDPediatrics Physician

Practice roles

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

Locations

175 Fulton Ave
Ste 100
Hempstead, NY 11550
Phone (516) 292-1034

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

222 Station Plz N
Ste 611
Mineola, NY 11501
Phone (516) 663-2532

Networks

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

Interoperability endpoints

  • Direct secure messaging: jlancenwahby255388@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.

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1942558010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N",
            "address_2": "SUITE 611",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013800",
            "telephone_number": "516-663-4938",
            "fax_number": "516-663-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FULTON AVE",
            "address_2": "#100",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115503718",
            "telephone_number": "516-292-1034",
            "fax_number": "516-292-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCEN-WAHBY",
        "first_name": "JESSICA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "278847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlancenwahby255388@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "175 Fulton Ave",
            "address_2": "#100",
            "city": "Hempstead",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115503718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hempstead, NY

Sources for this page

Verify at the official NPI Registry.