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

Jacquelyn Victory Dejesus

Individual provider Physician Assistant · NPI 1154153765

Jacquelyn Victory Dejesus is a Physician Assistant in New York, New York. Qualified in 2024, 2 years ago. Practices with Weill Medical College of Cornell, a 2,031-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2024
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Practice location Address checks out

525 E 68th St # 179
New York, NY 10065-4870
Phone: (212) 746-5454
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (NY)

Record details

NPI number1154153765
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 14, 2024
Last updated in NPPESAugust 14, 2024
Certification dateAugust 14, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Weill Medical College Of Cornell — 2031 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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