Individual provider Active NPI

Gayle Couleas, ANP-C

  • Nurse Practitioner
  • Hauppauge, NY
National Provider Identifier
1093722951
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F304244 Issued in NY
Practice address
694 Motor Pkwy
Suite 101
Hauppauge, NY 11788-5175
Phone
(631) 265-9355
Fax
(631) 864-8504
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F304244 NY Primary

Addresses

Primary practice location

694 Motor Pkwy
Suite 101
Hauppauge, NY 11788-5175

Mailing address

694 Motor Pkwy
Suite 101
Hauppauge, NY 11788-5175
Phone (631) 265-9355

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
304244NYMDFamily Medicine Physician
F304244NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roxanne G Carfora, DO, PC PastSince Jul 1, 2013 Accepting new patients
Main Street Medical, PC PastSince Mar 1, 2017 Accepting new patients

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1093722951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 MOTOR PKWY",
            "address_2": "SUITE 101",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885175",
            "telephone_number": "631-265-9355",
            "fax_number": "631-864-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 MOTOR PKWY",
            "address_2": "SUITE 101",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885175",
            "telephone_number": "631-265-9355",
            "fax_number": "631-864-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULEAS",
        "first_name": "GAYLE",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F304244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.