Individual provider Active NPI

Lynn-Marie Nitti, FNP

  • Family Nurse Practitioner
  • Middle Island, NY
National Provider Identifier
1164644035
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F330338 Issued in NY
Practice address
63 Middle Country Rd
Middle Island, NY 11953-2502
Phone
(631) 448-7800
Fax
(631) 775-9296
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F330338 NY Primary

Addresses

Primary practice location

63 Middle Country Rd
Middle Island, NY 11953-2502

Mailing address

63 Middle Country Rd
Middle Island, NY 11953-2502
Phone (631) 448-7800

Other identifiers 3

IdentifierTypeStateIssuer
95V052OtherNYOLD MEDICARE NUMBER
01790707MedicaidNY
A400028136OtherNYMEDICARE

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

LicenseStateTypeSpecialty
F330338NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1164644035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532502",
            "telephone_number": "631-448-7800",
            "fax_number": "631-775-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532502",
            "telephone_number": "631-448-7800",
            "fax_number": "631-775-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITTI",
        "first_name": "LYNN-MARIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F330338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD MEDICARE NUMBER",
            "identifier": "95V052",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01790707",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A400028136",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.