Active NPI
Minnette Montecillo
- Family Nurse Practitioner
- New York, NY
National Provider Identifier
1003499500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F347432-01
- Practice address
- 523 E 78TH St Apt 1E
New York, NY 10075-1164 - Phone
- (347) 797-7556
- NPI assigned
- May 3, 2021
- Last updated
- May 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 584658-01 | NY | |
| Family Nurse Practitioner | 363LF0000X | F347432-01 | NY | Primary |
Addresses
Primary practice location
523 E 78TH St Apt 1E
New York, NY 10075-1164
Mailing address
523 E 78TH St Apt 1E
New York, NY 10075-1164
Phone (347) 797-7556
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 584658-01 | NY | MD | Medical-Surgical Registered Nurse |
| F347432-01 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1003499500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 E 78TH ST APT 1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100751164",
"telephone_number": "347-797-7556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 E 78TH ST APT 1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100751164",
"telephone_number": "347-797-7556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTECILLO",
"first_name": "MINNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-03",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "NY",
"license": "584658-01",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F347432-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.