Individual provider Active NPI

Michael J Iadarola, RN

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1093599847
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
872905 Issued in NY
Practice address
46 Kirshon Ave
Staten Island, NY 10314-2706
Phone
(917) 589-8869
NPI assigned
Aug 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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 872905 NY Primary

Addresses

Primary practice location

46 Kirshon Ave
Staten Island, NY 10314-2706

Mailing address

46 Kirshon Ave
Staten Island, NY 10314-2706
Phone (917) 589-8869

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
872905NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1093599847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 KIRSHON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142706",
            "telephone_number": "917-589-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 KIRSHON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142706",
            "telephone_number": "917-589-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IADAROLA",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "872905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.