Individual provider Active NPI

Jennifer Busch, FNP-BC

  • Family Nurse Practitioner
  • Great Neck, NY
National Provider Identifier
1992505226
Registry record updated Aug 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F355861 Issued in NY
Practice address
865 Northern Blvd Ste 203
Great Neck, NY 11021-5310
Phone
(516) 708-2540
Fax
(516) 708-2573
NPI assigned
Mar 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2026

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 F355861 NY Primary

Addresses

Primary practice location

865 Northern Blvd Ste 203
Great Neck, NY 11021-5310

Mailing address

865 Northern Blvd Ste 203
Great Neck, NY 11021-5310
Phone (516) 708-2540

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
I20251212002338 NY Practitioner - Nurse Practitioner 9638663040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

865 Northern Boulevard
Suite 203
Great Neck, NY 11021-5310
Phone (855) 364-6257

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F355861NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Nov 1, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 1, 2025 Accepting new patients

Locations

865 Northern Blvd
Ste 203
Great Neck, NY 11021
Phone (516) 708-2540

300 Community Dr
Manhasset, NY 11030

Organizations & group practices 2

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": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786752000000",
    "number": "1992505226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 NORTHERN BLVD STE 203",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215310",
            "telephone_number": "516-708-2540",
            "fax_number": "516-708-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 NORTHERN BLVD STE 203",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215310",
            "telephone_number": "516-708-2540",
            "fax_number": "516-708-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "JENNIFER",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2026-08-15",
        "certification_date": "2026-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F355861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.