Sara Deborah Back, FNP MPH

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F333271 Issued in NY

Practice address

3424 Kossuth Ave
RM #3H17
Bronx, NY 10467-2410

Phone

(718) 519-3631

Fax

(718) 519-2034

NPI assigned

Sep 17, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: sara.back.1@24989.direct.athenahealth.com

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.

• Mission Medical Care PC

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1750898565

  Family

  Medicare reassignment NPD
• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1295729408
  Medicare reassignment NPD
• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1972877017
  NPD
• Fara Stricker Family Health Nurse Practitioner, P.C.

  • Infusion Therapy Clinic/Center
  • Rockville Centre, NY
  • NPI 1669162970
  NPD (past)
• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1126915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1104811991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 LASALLE ST",
            "address_2": "9C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274713",
            "telephone_number": "212-316-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVE",
            "address_2": "RM #3H17",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672410",
            "telephone_number": "718-519-3631",
            "fax_number": "718-519-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "SARA",
        "middle_name": "DEBORAH",
        "name_prefix": "Ms.",
        "credential": "FNP MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-17",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02108950",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moses Bachan, MD
• Gulnaz Naurozali Bachlani, MD
• Mena Bachu
• Danilo Bacic Lima, MD
• Back to Life Agency LLC
• Jefferson Solano Bacoling
• Stephen Bacon, PH.D.
• Janice Badal
• Amr Badawy, D.O.
• Sangita Bade, LPN

• Family Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.