Individual provider Active NPI

Alain Montesa Neri, NP

  • Adult Health Nurse Practitioner
  • Elmhurst, NY
National Provider Identifier
1063787760
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
306019 Issued in NY
Practice address
7901 Broadway
Elmhurst, NY 11373-1329
Phone
(718) 334-2460
NPI assigned
Mar 13, 2012
Last updated
Mar 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 306019 NY Primary

Addresses

Primary practice location

7901 Broadway
Elmhurst, NY 11373-1329

Mailing address

30 Miller Place Rd
Miller Place, NY 11764-2317
Phone (631) 509-1095

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
I20170713002069 NY Practitioner - Nurse Practitioner 2365711942 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John T Mather Memorial HospitalGroup PAC ID 1254237753, shared by 6 NPIs, 176 clinicians

Practice addresses (Care Compare)

125 Oakland Ave
Suite 305
Port Jefferson, NY 11777-2130
Phone (631) 686-2565

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
John T. Mather Memorial Hospital Current Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital CurrentSince Feb 22, 2021 Accepting new patients
John T. Mather Memorial Hospital CurrentSince Jun 1, 2017 Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
John T Mather Memorial Hospital CurrentSince Jun 1, 2017 Accepting new patients

Locations

125 Oakland Ave
Ste 305
Port Jefferson, NY 11777
Phone (631) 686-2565

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

Networks

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

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1063787760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MILLER PLACE RD",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642317",
            "telephone_number": "631-509-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERI",
        "first_name": "ALAIN",
        "middle_name": "MONTESA",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.