Jonathan Dillera Nietes, MSN, AGPC NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F309611 Issued in NY

Practice address

425 W 59TH St Ste 4F
New York, NY 10019-8022

Phone

(212) 241-1272

NPI assigned

Nov 5, 2020

Last updated

Feb 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Icahn School of Medicine at Mount Sinai

  dba Urology Department of Mount Sinai

  • Urology Physician
  • New York, NY
  • NPI 1750647152
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Icahn School of Medicine at Mount Sinai

  dba OB/GYN Department of Mount Sinai

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1124392212
  NPD (past)
• Icahn School of Medicine at Mount Sinai

  dba Ophthalmology Department of Mount Sinai

  • Ophthalmology Physician
  • New York, NY
  • NPI 1437421252
  NPD (past)

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1972104958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W 59TH ST STE 4F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100198022",
            "telephone_number": "917-982-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 59TH ST STE 4F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100198022",
            "telephone_number": "212-241-1272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4411 MacNish St Apt 1G",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113733609",
            "country_code": "US",
            "telephone_number": "917-982-6498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIETES",
        "first_name": "JONATHAN",
        "middle_name": "DILLERA",
        "credential": "MSN, AGPC NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ona Nierenberg, PHD
• Tori Nierenberg, MD
• David M Nierman, MD
• Frank J Niesuchouski, CRNA
• Ruben Niesvizky, MD
• Arianna Nieto
• Maria J Nieto, MD
• Yazmira T Nieto, MSW
• Karen Nieuchowicz, M.S.ED.
• Ashley M. Nieves Archibald

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.