VICKI JETTER MD
NPI 1639198633
Pediatrics in Baldwin Harbour, NY
About Vicki Jetter Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VICKI JETTER MD (NPI 1639198633) is an individual pediatrics provider in Baldwin Harbour, New York, licensed in New York (168846) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vicki Jetter Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Vicki Jetter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mount Kisco, NY 10549
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Optum Medical Care PC
- 1,601 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11510 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Vicki Jetter's NPI number?
The NPI number for Vicki Jetter is 1639198633. It was assigned to this individual provider in the NPPES registry on July 19, 2006.
Where is Vicki Jetter located?
Vicki Jetter practices at 860 Atlantic Ave, Baldwin Harbour, NY 11510. The listed phone number is (516) 868-6100.
What is Vicki Jetter's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Vicki Jetter enrolled in Medicare?
Yes. Vicki Jetter is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Vicki Jetter's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Vicki Jetter reassigns Medicare benefits to Optum Medical Care, P.C. (Mount Kisco, NY). The 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 Vicki Jetter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Vicki Jetter was last updated on September 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Vicki Jetter, MD · NPI 1639198633
Pediatrics physician in Baldwin Harbour, New York. Individual provider, active in the CMS NPPES registry since July 19, 2006.
## Identity
- **NPI:** 1639198633 (Entity type: Individual)
- **Enumerated:** July 19, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 168846 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 860 ATLANTIC AVE, Baldwin Harbour, NY 11510
- **Phone:** (516) 868-6100 · **Fax:** (516) 546-8621
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Optum Medical Care, P.C. (NPI 1982643003, Mount Kisco, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 5, 2012
- **Other identifiers:** Medicare UPIN E44844
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Source: [NPI Profile](https://npiprofile.com/npi/1639198633) · Data from the CMS NPPES public registry.