Individual provider Active NPI

Caroline Natalie Kardaszewski, FNP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1083365845
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349102 Issued in NY
Practice address
1360 Hylan Blvd
Staten Island, NY 10305-1922
Phone
(718) 667-3577
Fax
(718) 667-3043
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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 349102 NY Primary

Addresses

Primary practice location

1360 Hylan Blvd
Staten Island, NY 10305-1922

Mailing address

152 Baden PL
Staten Island, NY 10306-6054
Phone (646) 200-1188

Other practice location 1

860 5th Ave
New York, NY 10065-5856
Phone (212) 724-7246

Other practice location 2

1534 Victory Blvd
Staten Island, NY 10314-3548
Phone (718) 667-3577

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
I20230222001326 NY Practitioner - Nurse Practitioner 1951774975 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
349102NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Pain Consultant, PLLC CurrentSince Jan 1, 2023 Accepting new patients
Genovese Drug Stores Inc PastSince Jan 1, 2023 Accepting new patients

Locations

1534 Victory Blvd
Staten Island, NY 10314
Phone (718) 447-0055

1360 Hylan Blvd
Staten Island, NY 10305
Phone (718) 987-7300

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1083365845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 BADEN PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103066054",
            "telephone_number": "646-200-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051922",
            "telephone_number": "718-667-3577",
            "fax_number": "718-667-3043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 5th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100655856",
            "country_code": "US",
            "telephone_number": "212-724-7246",
            "fax_number": "212-724-7256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1534 Victory Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103143548",
            "country_code": "US",
            "telephone_number": "718-667-3577",
            "fax_number": "718-667-3043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KARDASZEWSKI",
        "first_name": "CAROLINE",
        "middle_name": "NATALIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.