Individual provider Active NPI

Jessica Hilsenroth, C.N.M.

  • Midwife
  • East Setauket, NY
National Provider Identifier
1962410175
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
F001196 Issued in NY
Practice address
6 Technology Dr
East Setauket, NY 11733
Phone
(631) 444-4686
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F001196 NY Primary

Addresses

Primary practice location

6 Technology Dr
East Setauket, NY 11733

Mailing address

P.O. Box 1559
Stony Brook, NY 11790

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060918000459 NY Practitioner - Certified Nurse Midwife (CNM) 9739184144 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F001196NYMDMidwife
001196NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jun 19, 2018 Accepting new patients

Locations

777 Larkfield Rd
Commack, NY 11725
Phone (631) 635-5100

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

270 Park Ave
Fl 1
Huntington, NY 11743
Phone (631) 351-2219

752 Park Ave
Huntington, NY 11743
Phone (631) 271-9017

300 Community Dr
Plandome, NY 11030

222 E Middle Country Rd
Ste 210
Smithtown, NY 11787
Phone (631) 265-6868

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: jessicahilsenroth@nslijmedgr.allscriptsdirect.net

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962410175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TECHNOLOGY DR",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-444-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILSENROTH",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F001196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.