Jaclyn C Abrahall, FNP-C, CDCES

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

343035 Issued in NY

Practice address

200 Motor Pkwy Ste C-16
Hauppauge, NY 11788-5114

Phone

(631) 638-4933

NPI assigned

Apr 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stony Brook Internists University Faculty Practice CorporationGroup PAC ID 9133019821, 427 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

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.

• Stony Brook Internists, University Faculty Practice Corporation

  • Endocrinology, Diabetes & Metabolism Physician
  • Stony Brook, NY
  • NPI 1356380471
  Medicare reassignment Care Compare group NPD
• Sayville Medical and Rehab PC

  • Physical Medicine & Rehabilitation Physician
  • Sayville, NY
  • NPI 1134659386
  Medicare reassignment NPD
• Riverhead Medical & Rehabilitation PC

  • Physical Medicine & Rehabilitation Physician
  • Massapequa, NY
  • NPI 1912519455
  NPD
• Setauket Medical & Rehabilitation PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • East Setauket, NY
  • NPI 1811509409
  NPD
• Stony Brook Internists, University Faculty Practice Corporation

  • Cardiac Rehabilitation Registered Nurse
  • Stony Brook, NY
  • NPI 1295778371
  NPD
• Jeffrey M Nakhjavan DO PC

  • Family Medicine Physician
  • North Babylon, NY
  • NPI 1578760005
  NPD (past)
• Stony Brook Internists, University Faculty Practice Corporation

  • Medical Oncology Physician
  • Stony Brook, NY
  • NPI 1184679342
  NPD (past)

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1972036333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MOTOR PKWY STE C-16",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885114",
            "telephone_number": "631-638-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MOTOR PKWY STE C-16",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885114",
            "telephone_number": "631-638-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHALL",
        "first_name": "JACLYN",
        "middle_name": "C",
        "credential": "FNP-C, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "695786",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 515 Physical Therapy LLC
• 523 Townline Dental PLLC
• Lauren Abelow
• Joseph A Abraham, PH.D.
• Lina Abu-Saab, OD
• Joanna V Acaylar, PT, DPT
• Lynnette Acevedo, DMD
• Bryanna Ackerman

• Family Nurse Practitioner in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.