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

Jenna Ditommaso

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1417595257

Jenna Ditommaso is a Physician Assistant in Massapequa Park, New York. Qualified in 2020, 6 years ago. Practices with New York University, a 5,884-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

4 Jones Ct
Massapequa Park, NY 11762-3235
Phone: (516) 633-5393
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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)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1417595257
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 11, 2019
Last updated in NPPESDecember 21, 2020
Certification dateDecember 21, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Massapequa Park