Desiree Cumbermack

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

254394 Issued in NY

Practice address

23218 Merrick Blvd
Laurelton, NY 11413-2115

Phone

(718) 528-3432

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Verdun Home Health Care Inc

  • Home Health Agency
  • Laurelton, NY
  • NPI 1174668149
  NPD (past)
• Verdun Home Health Care Inc

  • Home Health Agency
  • Laurelton, NY
  • NPI 1528357985
  NPD (past)

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1114179249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23218 MERRICK BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132115",
            "telephone_number": "718-528-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23218 MERRICK BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132115",
            "telephone_number": "718-528-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMBERMACK",
        "first_name": "DESIREE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "254394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010556898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Cooper, NURSE PRACTITIONER
• Sandra Coppin
• Deforest Cornish
• Sylvia Cothia
• Sheila Croskey, LCSW-R
• Donyale Cummings
• Paul M D'Amore, PHARMD
• Winsome Elise Daley
• Gail Miriam David
• Monique Ernestine Lois Davidson-Tucker, DDS

• Licensed Practical Nurse in Laurelton, NY
• Providers in Laurelton, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.