Active NPI
Jennifer Dyane Allen, NP
- Pediatric Nurse Practitioner
- New York, NY
National Provider Identifier
1982010260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- F382526-1
- Practice address
- 3959 Broadway
New York, NY 10032-1559 - Phone
- (212) 343-8530
- NPI assigned
- Jul 7, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Oncology Registered Nurse | 163WP0218X | 649661 | NY | |
| Pediatric Nurse Practitioner | 363LP0200X | F382526-1 | NY | Primary |
Addresses
Primary practice location
3959 Broadway
New York, NY 10032-1559
Mailing address
580 Saint Nicholas Ave Apt 4H
New York, NY 10030-1932
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 649661 | NY | MD | Pediatric Oncology Registered Nurse |
| F382526-1 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Pediatric Group | Current | Accepting new patients |
Locations
1275 York Ave
New York, NY 10065
Phone (212) 639-3813
633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- jallen38131@mskcc.direct-ci.com
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.
-
- Pediatrics Physician
- New York, NY
- NPI 1750352381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448409600000",
"number": "1982010260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 SAINT NICHOLAS AVE APT 4H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100301932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3959 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100321559",
"telephone_number": "212-343-8530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "JENNIFER",
"middle_name": "DYANE",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-07",
"last_updated": "2015-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0218X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatric Oncology",
"state": "NY",
"license": "649661",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "F382526-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.