Individual provider Active NPI

Nola Smith, FNP

  • Family Nurse Practitioner
  • Port Washington, NY
National Provider Identifier
1043616485
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95031742 Issued in CA
Practice address
58 Harbor Homes
Port Washington, NY 11050-7251
Phone
(516) 526-5416
NPI assigned
Nov 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95031742 CA Primary
General Practice Registered Nurse 163WG0000X 594909-1 NY
Family Nurse Practitioner 363LF0000X 344158 NY

Addresses

Primary practice location

58 Harbor Homes
Port Washington, NY 11050-7251

Mailing address

PO Box 1251
Port Washington, NY 11050-7251
Phone (516) 526-5416

Other practice location 1

55 Plaza Cir Ste C
Salinas, CA 93901-2952
Phone (831) 500-6960

Other identifiers 1

IdentifierTypeStateIssuer
04061583MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250127000230 CA Order and Referring Only - Nurse Practitioner 5395274039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
594909-1NYMDGeneral Practice Registered Nurse
344158NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Home Care Nursing Services LLC Family Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nola.smith.1@33563.direct.athenahealth.com
  • Direct secure messaging: nola.smith.1@24989.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1043616485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1251",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110507251",
            "telephone_number": "516-526-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 HARBOR HOMES",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110507251",
            "telephone_number": "516-526-5416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Plaza Cir Ste C",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939012952",
            "country_code": "US",
            "telephone_number": "831-500-6960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NOLA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031742",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "594909-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344158",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04061583",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.