Organization Active NPI

Total Care Adult Health, NP, PLLC

  • Adult Health Nurse Practitioner
  • Merrick, NY
National Provider Identifier
1043817885
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
TOTAL CARE ADULT HEALTH, NP, PLLC
Practice address
1401 Jerusalem Ave
Merrick, NY 11566-1342
Phone
(347) 385-6756
NPI assigned
Oct 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Ms. Amy NG Waldman, FNPNPI 1710203096
Title
Owner/Authorized Official
Phone
(347) 385-6756

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

1401 Jerusalem Ave
Merrick, NY 11566-1342

Mailing address

995 Orion CT
Merrick, NY 11566-1025
Phone (347) 385-6756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210118000024 NY Part B Supplier - Clinic/Group Practice 3577976364 Receives reassigned benefits from 1 practitioner
Practice locations: Merrick, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2194996Total Care Adult Health NP PLLC1401 Jerusalem Avenue, North Merrick, NY 11566Certificate of waiverOct 5, 2026

National Provider Directory

National Provider Directory

Locations

1401 Jerusalem Ave
Merrick, NY 11566
Phone (347) 385-6756

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1043817885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 ORION CT",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661025",
            "telephone_number": "347-385-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 JERUSALEM AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661342",
            "telephone_number": "347-385-6756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL CARE ADULT HEALTH, NP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "WALDMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "NG",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "347-385-6756",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.