Jack Winters, NP
Nurse Practitioner, Pediatrics in New York, NY. Individual provider (NPI-1).
NPI number1104607019
StatusActive
Last updated in NPPESOct 9, 2023
Details
- NPI
- 1104607019
- Entity type
- Individual (NPI-1)
- Name
- Jack Winters
- Credential
- NP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 9, 2023
- Certification date
- Oct 8, 2023
- Last updated
- Oct 9, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 383624 | NY | Yes |
Practice location
1468 Madison Ave Fl 3New York, NY 10029-6508
Phone 844-733-7692
Mailing address
442 Lorimer St Apt 14Brooklyn, NY 11206-1027
Phone 860-682-4399
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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