Individual provider Active NPI

Edwidge D Desgraves

  • Adult Health Nurse Practitioner
  • Hempstead, NY
National Provider Identifier
1013527258
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309713 Issued in NY
Practice address
129 Jackson St
Hempstead, NY 11550-2412
Phone
(212) 695-5122
NPI assigned
Aug 3, 2020
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309713 NY Primary

Addresses

Primary practice location

129 Jackson St
Hempstead, NY 11550-2412

Mailing address

997 Huckleberry Rd
North Bellmore, NY 11710-1913
Phone (516) 610-7071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211105001500 NY Practitioner - Nurse Practitioner 5799174140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Daniel S Berman MD Infectious Diseases PCGroup PAC ID 2567723562, 17 clinicians

Practice addresses (Care Compare)

1235 Pelham Pkwy N
Bronx, NY 10469-5817
Phone (718) 231-4300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.33 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
77.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309713NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel S. Berman, M.D., Infectious Diseases P.C. CurrentSince Dec 6, 2023 Accepting new patients

Locations

1235 Pelham Pkwy N
Bronx, NY 10469
Phone (718) 231-4300

14227 Franklin Ave
Flushing, NY 11355
Phone (516) 205-3663

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1013527258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 HUCKLEBERRY RD",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117101913",
            "telephone_number": "516-610-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 JACKSON ST",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115502412",
            "telephone_number": "212-695-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESGRAVES",
        "first_name": "EDWIDGE",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hempstead, NY

Sources for this page

Verify at the official NPI Registry.