Individual provider Active NPI

Denise Massaro, R. N

  • Registered Nurse
  • Coram, NY
National Provider Identifier
1144514779
Registry record updated Aug 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
640783-1 Issued in NY
Practice address
14 Glenmere LN
Coram, NY 11727
Phone
(631) 828-2761
NPI assigned
May 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 640783-1 NY
General Practice Registered Nurse 163WG0000X 640783-1 NY
Registered Nurse 163W00000X 640783-1 NY Primary

Addresses

Primary practice location

14 Glenmere LN
Coram, NY 11727

Mailing address

14 Glenmere LN
Coram, NY 11727-1424
Phone (631) 245-4976

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
640783-1NYMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534636800000",
    "number": "1144514779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 GLENMERE LN",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271424",
            "telephone_number": "631-245-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 GLENMERE LN",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "11727",
            "telephone_number": "631-828-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSARO",
        "first_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "R. N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2018-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NY",
            "license": "640783-1",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "640783-1",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "640783-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2018; 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.