Individual provider Active NPI

Maria Ann Clementi, NP

  • Pediatric Nurse Practitioner
  • Islandia, NY
National Provider Identifier
1043995632
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F383588 Issued in NY
Practice address
3001 Expressway Dr N Ste 100
Islandia, NY 11749-5301
Phone
(631) 434-1770
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F383588 NY Primary

Addresses

Primary practice location

3001 Expressway Dr N Ste 100
Islandia, NY 11749-5301

Mailing address

91 Dunlop Rd
Huntington, NY 11743-3936
Phone (516) 818-2425

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
I20231030001125 NY Practitioner - Nurse Practitioner 5698121598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Pediatrics of Suffolk County, P.C.Group PAC ID 6406151919, 2 clinicians

Practice addresses (Care Compare)

1770 Motor Pkwy
Islandia, NY 11749-5260
Phone (631) 434-1770

3001 Expressway Dr N
Suite 100
Islandia, NY 11749-5301
Phone (631) 434-1770

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F383588NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Pediatrics of Suffolk County, P.C. CurrentSince Sep 9, 2023 Accepting new patients
North Shore-Lij Medical PC CurrentSince Sep 9, 2023 Accepting new patients

Locations

1770 Motor Pkwy
Islandia, NY 11749
Phone (631) 434-1770

3001 Express Dr N
Ste 100
Islandia, NY 11749
Phone (631) 434-1770

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: mariaclementi@nslijmedgr.allscriptsdirect.net

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1043995632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 DUNLOP RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433936",
            "telephone_number": "516-818-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EXPRESSWAY DR N STE 100",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495301",
            "telephone_number": "631-434-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTI",
        "first_name": "MARIA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islandia, NY

Sources for this page

Verify at the official NPI Registry.