Individual provider Active NPI

Nadege Dorcelly, RN

  • Nurse Practitioner
  • Suffern, NY
National Provider Identifier
1154856169
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
405058 Issued in NY
Practice address
15 Suffern Place
Ste a
Suffern, NY 10901
Phone
(845) 357-4500
Fax
(845) 357-5039
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 405058 NY Primary
Registered Nurse 163W00000X 726867 NY

Addresses

Primary practice location

15 Suffern Place
Ste a
Suffern, NY 10901

Mailing address

15 Suffern Place
Ste a
Suffern, NY 10901
Phone (845) 357-4500

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
I20240724001381 NY Practitioner - Nurse Practitioner 1850837030 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
726867NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family & Childrens Services Inc Current Accepting new patients
Jewish Board of Family and Children'S Services, Inc. CurrentSince Jul 1, 2024 Accepting new patients
J&D Ultracare Corp PastSince Dec 13, 2020 Accepting new patients
Jewish Board of Family and Children'S Services, Inc Past Accepting new patients

Locations

3600 Jerome Ave
Bronx, NY 10467
Phone (718) 366-8400

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

2020 Coney Island Ave
Brooklyn, NY 11223
Phone (718) 676-4210

Organizations & group practices 4

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": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1154856169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SUFFERN PLACE",
            "address_2": "STE A",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-357-4500",
            "fax_number": "845-357-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SUFFERN PLACE",
            "address_2": "STE A",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-357-4500",
            "fax_number": "845-357-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORCELLY",
        "first_name": "NADEGE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "405058",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "726867",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.