PJS PROFESSIONAL NURSE PRACTITIONER IN ADULT HEALTH PLLC
NPI 1265863245
Skilled Nursing Facility in Port Jefferson Station, NY

Active since December 02, 2013
22 MISSISSIPPI AVE, PORT JEFFERSON STATION, NY 11776(631) 790-1239 Get Directions Write a Review

NPPES record last updated: December 2, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Pjs Professional Nurse Practitioner In Adult Health Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PJS PROFESSIONAL NURSE PRACTITIONER IN ADULT HEALTH PLLC (NPI 1265863245) is a healthcare organization registered as a skilled nursing facility in Port Jefferson Station, New York and active in the NPI registry since December 2013. The organization lists Luis J Ehrman, Owner, as its authorized official.

NPPES Registry Identity

NPI1265863245
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePJS PROFESSIONAL NURSE PRACTITIONER IN ADULT HEALTH PLLC
Location Address22 MISSISSIPPI AVEPort Jefferson Station, NY 11776-3012
Mailing Address22 Mississippi AvePort Jefferson Station, NY 11776-3012 · (631) 790-1239
Organization SubpartNo
Authorized OfficialLuis J EhrmanOwner · (631) 790-1239
Enumeration DateDecember 2, 2013
✔ NPI 1265863245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in NY · 304949
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
22 MISSISSIPPI AVE, Port Jefferson Station, NY 11776

Other Identifiers 1

Medicaid03075505NY

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pjs Professional Nurse Practitioner In Adult Health Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20140617001347Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pjs Professional Nurse Practitioner In Adult Health PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nurse Practitioner
NPI 1568617645
22 MISSISSIPPI AVE
Port Jefferson Station, NY 11776
(631) 476-7116
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pjs Professional Nurse Practitioner In Adult Health PLLC's NPI number?

The NPI number for Pjs Professional Nurse Practitioner In Adult Health PLLC is 1265863245. It was assigned to this organization in the NPPES registry on December 2, 2013.

Where is Pjs Professional Nurse Practitioner In Adult Health PLLC located?

Pjs Professional Nurse Practitioner In Adult Health PLLC is located at 22 Mississippi Ave, Port Jefferson Station, NY 11776. The listed phone number is (631) 790-1239.

What is Pjs Professional Nurse Practitioner In Adult Health PLLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Is Pjs Professional Nurse Practitioner In Adult Health PLLC enrolled in Medicare?

Yes. Pjs Professional Nurse Practitioner In Adult Health PLLC is registered in the Medicare PECOS enrollment system.

When is Pjs Professional Nurse Practitioner In Adult Health PLLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Pjs Professional Nurse Practitioner In Adult Health PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Pjs Professional Nurse Practitioner In Adult Health PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pjs Professional Nurse Practitioner In Adult Health PLLC was last updated on December 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.