Active NPI
Julie A Plantamura, ANPC
- Adult Health Nurse Practitioner
- Port Jefferson Station, NY
National Provider Identifier
1164428561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F333425
- Practice address
- 1500 Route 112 Ste 101
Port Jefferson Station, NY 11776-8054 - Phone
- (631) 751-3000
- Fax
- (631) 509-6559
- NPI assigned
- Jun 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F333425 | NY | Primary |
Addresses
Primary practice location
1500 Route 112 Ste 101
Port Jefferson Station, NY 11776-8054
Mailing address
1500 Route 112 Ste 101
Port Jefferson Station, NY 11776-8054
Phone (631) 751-0000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02219538 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F333425 | NY | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565136000000",
"number": "1164428561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 ROUTE 112 STE 101",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117768054",
"telephone_number": "631-751-0000",
"fax_number": "631-509-6559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 ROUTE 112 STE 101",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117768054",
"telephone_number": "631-751-3000",
"fax_number": "631-509-6559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLANTAMURA",
"first_name": "JULIE",
"middle_name": "A",
"credential": "ANPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-22",
"last_updated": "2019-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F333425",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02219538",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.