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

Jaclyn N Cotgreave, PA

Individual provider Physician Assistant · NPI 1659430205

Jaclyn N Cotgreave, PA is a Physician Assistant in Stony Brook, New York. Qualified in 2005, 21 years ago. Practices with Stony Brook Internists University Faculty Practice Corporation, a 428-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
21
Licensed in
NY
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

Department Of Med/cardiology Hsc T16-080 Stony Brook University
Stony Brook, NY 11794-0001
Phone: (631) 444-1106
Fax: (631) 444-2493
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 010753 (NY)

Record details

NPI number1659430205
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedDecember 8, 2006
Last updated in NPPESMarch 13, 2014
Mailing addressDepartment Of Med/Cardiology Hsc T16-080, Stony Brook University, Stony Brook, NY 11794-0001

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Stony Brook Internists University Faculty Practice Corporation — 428 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Stony Brook