Heather E Smith, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

356354 Issued in NY

Practice address

10209 217TH St
Queens Village, NY 11429-1128

Phone

(347) 858-0490

NPI assigned

Apr 25, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1745539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1164210795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10209 217TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10209 217TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291128",
            "telephone_number": "347-858-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HEATHER",
        "middle_name": "E",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-25",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "356354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SLB Medical Associates
• Lisa Marie Cohen Slone, LCSW-R
• SMC Health Supply LLC
• Delores Smith
• Dorret Smith
• Eric Brian Snitofsky, D.M.D.
• Kapildev Sohan, COTA L
• Jasmattie Sookram
• Amandah Sarah Soriano, OTR
• Ralph Soto, LMSW

• Family Nurse Practitioner in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.