Individual provider Active NPI

Karen Marie Mickaliger, REGISTERED NURSE

  • School Registered Nurse
  • Riverhead, NY
National Provider Identifier
1104124353
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
330756-1 Issued in NY
Practice address
1225 Ostrander Ave
Riverhead, NY 11901-2108
Phone
(631) 727-5900
Fax
(631) 727-8483
NPI assigned
Mar 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 330756-1 NY Primary

Addresses

Primary practice location

1225 Ostrander Ave
Riverhead, NY 11901-2108

Mailing address

700 Osborne Ave
Riverhead, NY 11901-2912
Phone (631) 727-5900

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

State licenses

LicenseStateTypeSpecialty
330756-1NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Riverhead Central School District Past Accepting new patients

Organizations & group practices 1

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": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1104124353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OSBORNE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012912",
            "telephone_number": "631-727-5900",
            "fax_number": "631-727-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 OSTRANDER AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012108",
            "telephone_number": "631-727-5900",
            "fax_number": "631-727-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKALIGER",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-10",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "330756-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.