Individual provider Active NPI

Mary Valentine McDonagh, N. P.

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1053566786
Registry record updated Nov 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F331738 Issued in NY
Practice address
170 W 12TH St
Spellman 691
New York, NY 10011-8202
Phone
(212) 604-8670
Fax
(212) 604-7828
NPI assigned
Nov 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2008

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 F331738 NY Primary

Addresses

Primary practice location

170 W 12TH St
Spellman 691
New York, NY 10011-8202

Mailing address

170 W 12TH St
Spellman 691
New York, NY 10011-8202
Phone (212) 604-8670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F331738NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1053566786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W 12TH ST",
            "address_2": "SPELLMAN 691",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118202",
            "telephone_number": "212-604-8670",
            "fax_number": "212-604-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W 12TH ST",
            "address_2": "SPELLMAN 691",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118202",
            "telephone_number": "212-604-8670",
            "fax_number": "212-604-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONAGH",
        "first_name": "MARY",
        "middle_name": "VALENTINE",
        "name_prefix": "Miss",
        "credential": "N. P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.