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

Jacqueline Fagoni, NP-C

Individual provider Family Nurse Practitioner · NPI 1801276118

Jacqueline Fagoni, NP-C is a Nurse Practitioner in Staten Island, New York. Qualified in 2014, 12 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
12
Licensed in
NJ, NY
In the registry since
2015
Specialties on file
2
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

1361 Hylan Blvd
Staten Island, NY 10305-1902
Phone: (888) 771-1874
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 33339339 (NY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 26NJ00567900 (NJ)

Record details

NPI number1801276118
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorNo
NPI enumeratedJune 2, 2015
Last updated in NPPESJanuary 30, 2016

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Staten Island