IndividualActive
Jessica Degonzague
NPI 1104217256 · Specialist · Ronkonkoma, NY
Jessica Degonzague is a Specialist provider in Ronkonkoma, NY (NPI 1104217256).
Provider details
- NPI number
- 1104217256
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
90 Air Park Dr
Ronkonkoma, NY 11779-7360
Phone: (631) 580-4001
Street-level locationGet directions
Mailing address
6 Birch Ave
Sound Beach, NY 11789-2534
Registry dates
- Enumerated
- 2015-02-11
- Last updated
- 2015-02-11
Frequently asked questions
- What is Jessica Degonzague's NPI number?
- Jessica Degonzague's National Provider Identifier (NPI) is 1104217256, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jessica Degonzague's specialty?
- Jessica Degonzague is listed in the NPPES registry with a primary specialty of Specialist (Other Service Providers).
- Where is Jessica Degonzague located?
- Jessica Degonzague's practice location on file with NPPES is 90 Air Park Dr, Ronkonkoma, NY 11779-7360.
- What is Jessica Degonzague's phone number?
- The practice phone number listed in the NPPES registry for Jessica Degonzague is (631) 580-4001.
- Is Jessica Degonzague's NPI active?
- Yes — Jessica Degonzague's NPI (1104217256) is active in the NPPES registry as of the last update on 2015-02-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.