JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) – Adult Health Nurse Practitioner, NPI 1033764006

JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) is a healthcare provider. based in Stony brook, New York. specializing in Adult Health Nurse Practitioner. They hold the professional credentials MS, RN, AGNP-C, CCRN. They hold a License No. F308885 (NY). The NPI Number for JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) is 1033764006

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN)
NPI
1033764006
Phone
(631) 444-1665
Address
101 NICHOLLS ROAD STONY BROOK HOSPITA
Enumeration Date
7 August 2019
Last Update Date
7 August 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6314440580
Graduation Year
2018 (8 years ago)
PAC ID
5193057081
Group Practice PAC ID
9133019821
Professional Enrollment ID
I20191025001090
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

Provider Addresses for JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN)

  • 101 NICHOLLS ROAD STONY BROOK HOSPITA

    STONY BROOK, NY 117940001

    Phone: (631) 444-1665

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $248.

Total Amount is formed as General ($248) + Research ($0) + Ownership ($0) = $248.

Last reported payment date: 2023-08-16 • Largest payer in this snapshot: Insulet Corporation ($248).

Total Amount

$248

General + Research + Ownership

Payments

2

Total payment records

General Amount

$248

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-16

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Insulet Corporation$248
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-10-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191025001090INurse PractitionerNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 11794)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9133019821View full group profile
NameSpecialtyState
-NY
H O S P I T A L I S TNY
E N D O C R I N O L O G YNY
Internal MedicineNY
Internal MedicineNY
G A S T R O E N T E R O L O G YNY
Physician AssistantGA
Geriatric Medicine, Internal MedicineNY
H O S P I T A L I S TCT
H O S P I T A L I S TNY

Reviews

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Frequently asked questions

What identifier follows JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) across health systems?
The NPI 1033764006 uniquely identifies JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) in U.S. healthcare data.
Quick check: is JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) active?
Public NPPES data shows JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) with an active NPI status right now.
What does the directory say JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) does?
Insurance directories may phrase it differently, but here JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) maps to Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN)?
JEANINE MICHELLE CARNIVAL (MS, RN, AGNP-C, CCRN) shows a connection to Stony Brook, New York in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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