Individual provider Active NPI

Phyllis J. Bartoletti, R.N.

  • Registered Nurse
  • Nesconset, NY
National Provider Identifier
1013195775
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
525599-1 Issued in NY
Practice address
21A Walter Dr
Nesconset, NY 11767-3042
Phone
(631) 588-1766
NPI assigned
Feb 5, 2008
Last updated
Feb 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 525599-1 NY Primary

Addresses

Primary practice location

21A Walter Dr
Nesconset, NY 11767-3042

Mailing address

21A Walter Dr
Nesconset, NY 11767-3042
Phone (631) 588-1766

Other identifiers 1

IdentifierTypeStateIssuer
525599-1MedicaidNY

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
525599-1NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1013195775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21A WALTER DR",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117673042",
            "telephone_number": "631-588-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21A WALTER DR",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117673042",
            "telephone_number": "631-588-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOLETTI",
        "first_name": "PHYLLIS",
        "middle_name": "J.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "525599-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "525599-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.