Individual provider Active NPI

Claridge Henriquez

  • Family Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1013882125
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
357035 Issued in NY
Practice address
20 Thompson St
Valley Stream, NY 11580-2037
Phone
(347) 968-8015
NPI assigned
Oct 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 357035 NY Primary

Addresses

Primary practice location

20 Thompson St
Valley Stream, NY 11580-2037

Mailing address

20 Thompson St
Valley Stream, NY 11580-2037

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
I20260212000042 NY Practitioner - Nurse Practitioner 8729567458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

700 Hicksville Rd
Bethpage, NY 11714-3471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
357035NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Multi-Specialty CurrentSince Feb 1, 2026 Accepting new patients
New York University Multi-Specialty CurrentSince Feb 1, 2026 Accepting new patients
New York University Multi-Specialty CurrentSince Feb 1, 2026 Accepting new patients

Locations

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

Organizations & group practices 4

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": "1759881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1013882125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 THOMPSON ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 THOMPSON ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802037",
            "telephone_number": "347-968-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIQUEZ",
        "first_name": "CLARIDGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-08",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.