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Jennifer Marie Spisak

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

This provider is enrolled in PECOS as JENNIFER SPISAK.

Based on the most recent information from CMS, provider Jennifer Marie Spisak is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1467892430
Provider Type
Individual
Full Name
Spisak, Jennifer Marie
Credential
P.A.

Gender
Female
Sole Proprietor
No
Enumeration Date
7/5/2013
Last Updated
4/2/2021

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

(718) 226-6964

Mailing Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

(718) 226-6964

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 016587 New York

Jennifer Marie Spisak

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Russo, James Vincent

Gregory, Krista Ann

Hanna, Catherine

Lipnitskiy, Mona Trinette

Izmikna, Shadi

Sanchez, Alexandra

Peduto, Nicole

Marchese, Robert Vito

Guadagno, Lynn Marie

Rakvin, Magdalena