Active NPI
Paz Menjivar, AGNP
- Primary Care Nurse Practitioner
- New Hyde Park, NY
National Provider Identifier
1053964650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- F308833-1
- Practice address
- 1991 Lakeville Rd
New Hyde Park, NY 11040-1972 - Phone
- (516) 428-9821
- NPI assigned
- Jul 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | F308833-1 | NY | Primary |
Addresses
Primary practice location
1991 Lakeville Rd
New Hyde Park, NY 11040-1972
Mailing address
1991 Lakeville Rd
New Hyde Park, NY 11040-1972
Phone (516) 428-9821
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F308833-1 | NY | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1053964650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1991 LAKEVILLE RD",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110401972",
"telephone_number": "516-428-9821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1991 LAKEVILLE RD",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110401972",
"telephone_number": "516-428-9821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENJIVAR",
"first_name": "PAZ",
"credential": "AGNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-23",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NY",
"license": "F308833-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.