Individual provider Active NPI

Jennifer Egbert, F.N.P.

  • Family Nurse Practitioner
  • Oceanside, NY
National Provider Identifier
1992244321
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33 341475 Issued in NY
Practice address
187 Dot CT E
Oceanside, NY 11572-5920
Phone
(516) 764-3310
NPI assigned
Feb 17, 2017
Last updated
Sep 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 33 341475 NY Primary

Addresses

Primary practice location

187 Dot CT E
Oceanside, NY 11572-5920

Mailing address

187 Dot CT E
Oceanside, NY 11572-5920
Phone (516) 764-3310

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
I20180813001370 NY Practitioner - Nurse Practitioner 4183972839 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33 341475NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York Spine Medicine and Surgery PLLC CurrentSince Jan 14, 2022 Accepting new patients

Locations

285 Sills Rd
Bldg 5-6G
East Patchogue, NY 11772
Phone (631) 654-0335

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1992244321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 DOT CT E",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115725920",
            "telephone_number": "516-764-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 DOT CT E",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115725920",
            "telephone_number": "516-764-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBERT",
        "first_name": "JENNIFER",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33 341475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.