JACQUELINE S PHILLIP
NPI 1821879867
Nurse Practitioner in Staten Island, NY
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
4Medicare enrollment records show Jacqueline Phillip reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bronx, NY 10452
- Reassigned Medicare billing, New York enrollment
- 272 clinicians in this Medicare group
Bronx, NY 10453
- Reassigned Medicare billing, New York enrollment
- 1,393 clinicians in this Medicare group
Bronx, NY 10461
- Reassigned Medicare billing, New York enrollment
- 1,054 clinicians in this Medicare group
Bronx, NY 10461
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Bronx Medical Practice PC
- 1,013 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 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.
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.
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.
Which organizations bill Medicare for Jacqueline Phillip's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Phillip reassigns Medicare benefits to 4 organizations: Shakespeare Operating LLC (Bronx, NY), Essen Medical Associates, PC (Bronx, NY), House Call Medical Services Of New York, PLLC (Bronx, NY) and Bronx Medical Practice P.C. (Bronx, NY). Each 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 Jacqueline Phillip'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 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 3 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.
# Jacqueline S Phillip · NPI 1821879867
Nurse Practitioner physician in Staten Island, New York. Individual provider, active in the CMS NPPES registry since October 6, 2023.
## Identity
- **NPI:** 1821879867 (Entity type: Individual)
- **Enumerated:** October 6, 2023
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** F405202-1 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1915 FOREST AVE, Staten Island, NY 10303-2127
- **Phone:** (718) 981-3136
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Shakespeare Operating LLC (NPI 1720634538, Bronx, NY); Essen Medical Associates, PC (NPI 1366418709, Bronx, NY); House Call Medical Services Of New York, PLLC (NPI 1851345946, Bronx, NY); Bronx Medical Practice P.C. (NPI 1356726087, Bronx, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** October 6, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1821879867) · Data from the CMS NPPES public registry.