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

Jessica Dezego, PA-C

Individual provider Physician Assistant · NPI 1407327794

Jessica Dezego, PA-C is a Physician Assistant in Brightwaters, New York. Qualified in 2018, 8 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

404 Potter Blvd
Brightwaters, NY 11718-1830
Phone: (631) 376-0055
Show map & directions

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

Additional practice locations (1)

  • 301 E Main St, Bay Shore, NY 11706-8408 — (631) 968-3000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 022967 (NY)

Record details

NPI number1407327794
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 11, 2018
Last updated in NPPESSeptember 5, 2023
Certification dateSeptember 5, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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