Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jaclyn Kristin Shea

Individual provider Family Nurse Practitioner · NPI 1861168411

Jaclyn Kristin Shea is a Nurse Practitioner in Medford, New York. Qualified in 2021, 5 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2021

Practice location Address checks out

1723 N Ocean Ave
Medford, NY 11763-2687
Phone: (631) 758-5858
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 348300 (NY)

Record details

NPI number1861168411
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 23, 2021
Last updated in NPPESMarch 10, 2022
Certification dateMarch 10, 2022
Mailing address7 Corky Ct, Blue Point, NY 11715-1108

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Medford