Active NPI
Mary Infantino, APRN, BC
- Physician Assistant
- Hempstead, NY
National Provider Identifier
1164645404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- F3006741
- Practice address
- 540 Fulton Ave
Hempstead, NY 11550-4364 - Phone
- (516) 750-2500
- Fax
- (516) 483-3592
- NPI assigned
- Apr 11, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | F3006741 | NY | Primary |
Addresses
Primary practice location
540 Fulton Ave
Hempstead, NY 11550-4364
Mailing address
6 E Slope Rd
Bayville, NY 11709-2112
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151026000908 | NY | Order and Referring Only - Nurse Practitioner | 2466761812 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F3006741 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164645404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 E SLOPE RD",
"city": "BAYVILLE",
"state": "NY",
"postal_code": "117092112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 FULTON AVE",
"city": "HEMPSTEAD",
"state": "NY",
"postal_code": "115504364",
"telephone_number": "516-750-2500",
"fax_number": "516-483-3592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INFANTINO",
"first_name": "MARY",
"credential": "APRN, BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "F3006741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hempstead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.