Organization Active NPI

The Vine NP Family Health, PLLC

  • Family Nurse Practitioner
  • Queens Village, NY
National Provider Identifier
1154078335
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
THE VINE NP FAMILY HEALTH, PLLC
Practice address
11358 212TH St
Queens Village, NY 11429-2312
Phone
(718) 954-3553
Fax
(877) 762-6647
NPI assigned
Mar 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Authorized official

Name
Kelly Hilaire, FNPNPI 1043883572
Title
Owner
Phone
(718) 233-9122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

11358 212TH St
Queens Village, NY 11429-2312

Mailing address

11944 218TH St
Cambria Heights, NY 11411-1911
Phone (718) 954-3553

Other practice location 1

230 Hilton Ave Ste 105
Hempstead, NY 11550-8116
Phone (718) 954-3553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220607000356 NY Part B Supplier - Clinic/Group Practice 9436537271 Receives reassigned benefits from 2 practitioners
Practice locations: Hempstead, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1154078335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11944 218TH ST",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111911",
            "telephone_number": "718-954-3553",
            "fax_number": "877-762-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11358 212TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292312",
            "telephone_number": "718-954-3553",
            "fax_number": "877-762-6647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Hilton Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115508116",
            "country_code": "US",
            "telephone_number": "718-954-3553",
            "fax_number": "877-762-6647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE VINE NP FAMILY HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-07",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "HILAIRE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-233-9122",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.