Individual provider Active NPI

Candace Coakley-Assefa

  • Registered Nurse
  • Bay Shore, NY
National Provider Identifier
1083525232
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
616776 Issued in NY
Practice address
250 E Main St
Bay Shore, NY 11706-8442
Phone
(631) 665-0027
Fax
(631) 665-0172
NPI assigned
Sep 16, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 616776 NY Primary

Addresses

Primary practice location

250 E Main St
Bay Shore, NY 11706-8442

Mailing address

38 Timber Ridge Dr
Holbrook, NY 11741-4148

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1083525232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 TIMBER RIDGE DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068442",
            "telephone_number": "631-665-0027",
            "fax_number": "631-665-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAKLEY-ASSEFA",
        "first_name": "CANDACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "616776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.