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JENNA GOTTLIEB PA-C
NPI 1902447766
Physician Assistant - Surgical in New York, NY

Active since October 03, 2019PECOS Enrolled
1901 1ST AVE, NEW YORK, NY 10029(631) 275-9695 Get Directions Write a Review

NPPES record last updated: January 17, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 17, 2021, Apr 21, 2020, Dec 9, 2019 and 1 more (4 updates tracked since 2019).

About Jenna Gottlieb Pa-c NPPES

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

JENNA GOTTLIEB PA-C (NPI 1902447766) is an individual surgical provider in New York, New York, licensed in New York (024214) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902447766
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameJENNA GOTTLIEBCredential: PA-C
Location Address1901 1ST AVENew York, NY 10029-7491
Mailing Address1901 1st AveNew York, NY 10029-7494 · (212) 423-6416
Phone(631) 275-9695
Sole ProprietorNo
Enumeration DateOctober 3, 2019
Last NPPES UpdateJanuary 17, 20214 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2021
✔ NPI 1902447766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NY · 024214
1901 1ST AVE, New York, NY 10029
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jenna Gottlieb Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

KENNETH BOMPAROLA PA
Physician Assistant
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6262
ESEOGHENE INYANG AKAMUNE PHARMD
Pharmacist (Pharmacotherapy)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6262
JONATHAN CHABON MD
Emergency Medicine
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6684
KRITI BHANDARI MD
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
New York County (646) 988-5168
SEBASTIAN MARK MENDEZ
Psychiatry & Neurology (Psychiatry)
1901 1ST AVE
NEW YORK, NY 10029
New York County (646) 672-3143
KYRA QUYNN MANAYAN-LEONARD MD
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
New York County (844) 692-4692
ELENA ALAYETO LCSW
Social Worker (Clinical)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-8633
BEATA EDYTA POPIS-MATEJAK MD
Internal Medicine (Critical Care Medicine)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6771

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 Jenna Gottlieb's NPI number?

The NPI number for Jenna Gottlieb is 1902447766. It was assigned to this individual provider in the NPPES registry on October 3, 2019.

Where is Jenna Gottlieb located?

Jenna Gottlieb practices at 1901 1st Ave, New York, NY 10029. The listed phone number is (631) 275-9695.

What is Jenna Gottlieb's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jenna Gottlieb enrolled in Medicare?

Yes. Jenna Gottlieb is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jenna Gottlieb was last updated on January 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.