JACLYN M NELSON FNP
NPI 1801392683
Nurse Practitioner - Family in Bay Shore, NY
About Jaclyn M Nelson Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACLYN M NELSON FNP (NPI 1801392683) is an individual family provider in Bay Shore, New York, licensed in New York (342618) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jaclyn M Nelson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jaclyn Nelson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New Hyde Park, NY 11040
- Reassigned Medicare billing, New York enrollment
- 9,353 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 11706 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BAY SHORE, NY 11706
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 Jaclyn Nelson's NPI number?
The NPI number for Jaclyn Nelson is 1801392683. It was assigned to this individual provider in the NPPES registry on April 2, 2018.
Where is Jaclyn Nelson located?
Jaclyn Nelson practices at 250 E Main St, Bay Shore, NY 11706. The listed phone number is (631) 390-7100.
What is Jaclyn Nelson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jaclyn Nelson enrolled in Medicare?
Yes. Jaclyn Nelson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jaclyn Nelson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Nelson reassigns Medicare benefits to North Shore - Lij Medical PC (New Hyde Park, 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 Jaclyn Nelson'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 Jaclyn Nelson was last updated on August 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Jaclyn M Nelson, FNP · NPI 1801392683
Family physician in Bay Shore, New York. Individual provider, active in the CMS NPPES registry since April 2, 2018.
## Identity
- **NPI:** 1801392683 (Entity type: Individual)
- **Enumerated:** April 2, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 342618 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 250 E MAIN ST, Bay Shore, NY 11706-8442
- **Phone:** (631) 390-7100
## 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:** North Shore - Lij Medical PC (NPI 1790043479, New Hyde Park, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 26, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1801392683) · Data from the CMS NPPES public registry.