Individual provider Active NPI

Yolanda Pena

  • Registered Nurse
  • Flushing, NY
National Provider Identifier
1114584646
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
572637-1 Issued in NY
Practice address
3521 81St St Apt 6a
Flushing, NY 11372-5005
Phone
(718) 316-3066
NPI assigned
May 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 572637-1 NY Primary

Addresses

Primary practice location

3521 81St St Apt 6a
Flushing, NY 11372-5005

Mailing address

3521 81St St Apt 6a
Flushing, NY 11372-5005
Phone (718) 316-3066

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
572637-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1114584646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 81ST ST APT 6A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113725005",
            "telephone_number": "718-316-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 81ST ST APT 6A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113725005",
            "telephone_number": "718-316-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "YOLANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "572637-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.