Individual provider Active NPI

Jenica Rusu, NP

  • Nurse Practitioner
  • Briarwood, NY
National Provider Identifier
1972184323
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F347376 Issued in NY
Practice address
14445 87TH Ave
Briarwood, NY 11435-3109
Phone
(718) 906-9980
Fax
(718) 906-9989
NPI assigned
Apr 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F347376 NY
Nurse Practitioner 363L00000X F347376 NY Primary

Addresses

Primary practice location

14445 87TH Ave
Briarwood, NY 11435-3109

Mailing address

30 Cornell Dr
Great Neck, NY 11020-1128
Phone (917) 599-6361

Other names 1

  • Jeni Rusu Other name

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address IKF9003@direct.nyp.org Direct

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
I20210723000778 NY Practitioner - Nurse Practitioner 6406259753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Queens Medicine and Surgery, P.C.Group PAC ID 4082883673, 401 clinicians

Practice addresses (Care Compare)

14445 87TH Ave
Briarwood, NY 11435-3109
Phone (718) 480-4026

Hospital & facility affiliations

  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F347376NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Services, P.C. CurrentSince Jun 1, 2021 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Feb 28, 2023 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Feb 28, 2023 Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

14445 87th Ave
Jamaica, NY 11435
Phone (718) 239-0030

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

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

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

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

Interoperability endpoints

  • Direct secure messaging: ikf9003@direct.nyp.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1972184323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CORNELL DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110201128",
            "telephone_number": "917-599-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 87TH AVE",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114353109",
            "telephone_number": "718-906-9980",
            "fax_number": "718-906-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSU",
        "first_name": "JENICA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-17",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F347376",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F347376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "14445 87th Ave",
            "city": "Briarwood",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114353109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "14445 87th Ave",
            "city": "Briarwood",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114353109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "IKF9003@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "14445 87th Ave",
            "city": "Briarwood",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114353109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENI",
            "last_name": "RUSU",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Briarwood, NY

Sources for this page

Verify at the official NPI Registry.