Individual provider Active NPI

Taylor Marie Raia, FNP

  • Family Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1013606706
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351339 Issued in NY
Practice address
260 W Sunrise Hwy FL 3
Valley Stream, NY 11581-1011
Phone
(516) 336-5255
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 351339 NY Primary

Addresses

Primary practice location

260 W Sunrise Hwy FL 3
Valley Stream, NY 11581-1011

Mailing address

58 Fleetwood Rd
Commack, NY 11725-1761
Phone (631) 905-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
351339NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Jun 1, 2023 Accepting new patients
Samaritan Medical Services, P.C. CurrentSince Sep 10, 2023 Accepting new patients

Locations

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

1 Research Rd
Ridge, NY 11961

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

260 W Sunrise Hwy
Fl 3
Valley Stream, NY 11581
Phone (516) 336-5255

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1013606706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 FLEETWOOD RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251761",
            "telephone_number": "631-905-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 W SUNRISE HWY FL 3",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811011",
            "telephone_number": "516-336-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIA",
        "first_name": "TAYLOR",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.