Individual provider Active NPI

Alexandra M Lamothe, FNP

  • Family Nurse Practitioner
  • E Patchogue, NY
National Provider Identifier
1114235637
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336182-1 Issued in NY
Practice address
801 Gazzola Dr
E Patchogue, NY 11772-4900
Phone
(631) 447-8800
NPI assigned
Sep 17, 2010
Last updated
Sep 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336182-1 NY Primary

Addresses

Primary practice location

801 Gazzola Dr
E Patchogue, NY 11772-4900

Mailing address

1574 August Rd
North Babylon, NY 11703-1933
Phone (631) 804-7836

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110609000087 NY Practitioner - Nurse Practitioner 8022295567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F336182-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookhaven Health Care Facility LLC CurrentSince Mar 4, 2011 Accepting new patients

Locations

455 Cayuga Rd
Ste 200
Cheektowaga, NY 14225

801 Gazzola Dr
East Patchogue, NY 11772
Phone (631) 447-8800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1114235637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 AUGUST RD",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117031933",
            "telephone_number": "631-804-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 GAZZOLA DR",
            "city": "E PATCHOGUE",
            "state": "NY",
            "postal_code": "117724900",
            "telephone_number": "631-447-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMOTHE",
        "first_name": "ALEXANDRA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336182-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in E Patchogue, NY

Sources for this page

Verify at the official NPI Registry.