JACQUELINE S PHILLIP
NPI 1821879867
Nurse Practitioner in Staten Island, NY

Active since October 06, 2023PECOS EnrolledAccepts Medicare Assignment
1915 FOREST AVE, STATEN ISLAND, NY 10303(718) 981-3136 Get Directions Write a Review

NPPES record last updated: October 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jacqueline S Phillip NPPES

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

JACQUELINE S PHILLIP (NPI 1821879867) is an individual nurse practitioner in Staten Island, New York, licensed in New York (F405202-1) and active in the NPI registry since October 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1821879867
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameJACQUELINE S PHILLIP
Location Address1915 FOREST AVEStaten Island, NY 10303-2127
Mailing Address42 Hancock LnManalapan, NJ 07726-8911 · (732) 403-9107
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 6, 2023
NPPES CertifiedOctober 6, 2023
NPI 1821879867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in NY · F405202-1
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1915 FOREST AVE, Staten Island, NY 10303

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jacqueline S Phillip is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133636871
PECOS Enrollment IDI20250729000091
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10303 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
1915 FOREST AVE
STATEN ISLAND, NY 10303
Registered Nurse
1915 FOREST AVE
STATEN ISLAND, NY 10303
Social Worker
1915 FOREST AVE
STATEN ISLAND, NY 10303
Registered Nurse
1915 FOREST AVE
STATEN ISLAND, NY 10303
Counselor (Mental Health)
1915 FOREST AVE
STATEN ISLAND, NY 10303
Social Worker
1915 FOREST AVE
STATEN ISLAND, NY 10303
Counselor (Mental Health)
1915 FOREST AVE
STATEN ISLAND, NY 10303
Registered Nurse
1915 FOREST AVE
STATEN ISLAND, NY 10303

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 Jacqueline Phillip's NPI number?

The NPI number for Jacqueline Phillip is 1821879867. It was assigned to this individual provider in the NPPES registry on October 6, 2023.

Where is Jacqueline Phillip located?

Jacqueline Phillip practices at 1915 Forest Ave, Staten Island, NY 10303. The listed phone number is (718) 981-3136.

What is Jacqueline Phillip's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jacqueline Phillip enrolled in Medicare?

Yes. Jacqueline Phillip is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jacqueline Phillip was last updated on October 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.