Annamaria Pepitone, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Shirley, NY
NPI 1003069709 · NPPES record last updated Feb 24, 2023
Key facts
- NPI
- 1003069709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F335179-1 (NY)
- Practice address
- 2 Coraci Blvd Ste 10
Shirley, NY 11967-4833 - Phone
- (631) 281-2600
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- State University of New York at Stony Brook, School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Brookhaven Heart PLLC
Practice addresses (Care Compare)
325 E Main St
Suite 120
Patchogue, NY 11772-3114
Phone (631) 654-3278
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090514000003 | NY | Practitioner - Nurse Practitioner | 1153470554 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 335179 | NY | MD | Licensed Practical Nurse |
| F335179-1 | NY | MD | Family Nurse Practitioner |
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brookhaven Heart PLLC | Current |
Accepting new patients | |
| Suffolk Home Care LLC | Current |
Accepting new patients | |
| Kumar S Mandal MD PC | Current |
Accepting new patients | |
| Scott a. Mayerberger M.D.,P.C. | Past |
Accepting new patients |
Locations
325 E Main St
Ste 120
Patchogue, NY 11772
Phone (631) 654-3278
2 Coraci Blvd
Ste 10
Shirley, NY 11967
Phone (631) 281-2600
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EEFCAA
- https://fhir4.healow.com/fhir/r4/EEFCAA/Endpoint/EEFCAA
- https://fhir4.healow.com/fhir/r4/EGHDDD/Endpoint/EGHDDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F335179-1 | NY | |
| Family Nurse Practitioner | 363LF0000X | F335179-1 | NY | Yes |
Addresses
Primary practice location
2 Coraci Blvd Ste 10
Shirley, NY 11967-4833
Mailing address
7 Manhasset TRL
Ridge, NY 11961-2281
Phone (631) 745-7334
Other practice location 1
1490 William Floyd Parkway
Suite 105
Yaphank, NY 11980
Phone (631) 475-7700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003069709 | Other | ANTHEM |
Other providers in Shirley, NY
- Pamela a Weber MD PC
- Pathmark Stores Inc
- Amandy Patino
- Eileen Marie Pedreira
- Shannon Naomi Pendergast
- Bianca Pereira
- Elyhia Perez-Cruz
- Personal Touch Home Care of Long Island, Inc.
- Kimberly Michelle Pesiri
- Peter Taormino
All providers in Shirley, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.