Individual provider Active NPI

Jessica Maria Kiernan, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • West Islip, NY
National Provider Identifier
1942845193
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309407 Issued in NY
Practice address
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone
(631) 376-3183
NPI assigned
Nov 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309407 NY Primary

Addresses

Primary practice location

1000 Montauk Hwy
West Islip, NY 11795-4927

Mailing address

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3183

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200312000160 NY Practitioner - Nurse Practitioner 1355779083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.12 of 100Reported as group
Quality
88.22
Promoting interoperability
100
Improvement activities
40
Cost
73.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital CurrentSince Jan 1, 2022 Accepting new patients
St. Francis Hospital Current Accepting new patients
Samaritan Medical Services, P.C. CurrentSince Feb 1, 2020 Accepting new patients
St Francis Hospital CurrentSince Jan 1, 2022 Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

540 Union Blvd
West Islip, NY 11795
Phone (631) 669-2555

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Interoperability endpoints

  • Direct secure messaging: jkiernan37086@direct-chsli.net

Organizations & group practices 5

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": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1942845193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-376-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "JESSICA",
        "middle_name": "MARIA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.