Individual provider Active NPI

Nioleden Jean-Joseph, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Uniondale, NY
National Provider Identifier
1134544372
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F354503 Issued in NY
Practice address
833 Davis Ave
Uniondale, NY 11553-2836
Phone
(516) 754-8487
NPI assigned
Feb 25, 2014
Reactivated
Sep 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 679038 NY
Family Nurse Practitioner 363LF0000X F354503 NY Primary

Addresses

Primary practice location

833 Davis Ave
Uniondale, NY 11553-2836

Mailing address

196 W 24TH St
Deer Park, NY 11729-4837
Phone (516) 754-8487

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
I20250508001862 NY Practitioner - Nurse Practitioner 3375060734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Shore Magnetic Resonance Imaging Associates PCGroup PAC ID 8729991971, 9 clinicians

Practice addresses (Care Compare)

81 Louden Ave
Amityville, NY 11701-2736
Phone (631) 789-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
679038NYMDRegistered Nurse
F354503NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Solutions P.C. CurrentSince Mar 28, 2025 Accepting new patients
South Shore Magnetic Resonance Imaging Associates PC CurrentSince Apr 1, 2025 Accepting new patients

Locations

81 Louden Ave
Amityville, NY 11701
Phone (631) 789-7000

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

275 W Merrick Rd
Freeport, NY 11520
Phone (516) 377-2946

154 Prospect Ave
Plattsburgh, NY 12901
Phone (518) 563-5440

Organizations & group practices 2

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": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1134544372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 W 24TH ST",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294837",
            "telephone_number": "516-754-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 DAVIS AVE",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115532836",
            "telephone_number": "516-754-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN-JOSEPH",
        "first_name": "NIOLEDEN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-25",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "deactivation_date": "2024-07-04",
        "reactivation_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "679038",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F354503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniondale, NY

Sources for this page

Verify at the official NPI Registry.