Individual provider Active NPI

Pattie N Walton, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1164670303
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334488-1 Issued in NY
Practice address
445 Park Ave
Brooklyn, NY 11205-2735
Phone
(718) 963-0800
Fax
(718) 534-5221
NPI assigned
Aug 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 400461-1 NY
Family Nurse Practitioner 363LF0000X F334488-1 NY Primary

Addresses

Primary practice location

445 Park Ave
Brooklyn, NY 11205-2735

Mailing address

255 Sea Cliff St
Islip Terrace, NY 11752-1106
Phone (631) 650-5964

Other practice location 1

255 Sea Cliff St
Islip Terrace, NY 11752-1106
Phone (631) 650-5964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
400461-1NYMDRegistered Nurse
F334488-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Avenue Pediatrics, P.C. CurrentSince Aug 17, 2019 Accepting new patients
Parcare Community Health Network Inc CurrentSince Aug 17, 2019 Accepting new patients
Parcare Community Health Network Inc CurrentSince Aug 17, 2019 Accepting new patients
Suffolk Medical PC Past Accepting new patients

Locations

3400 Cannon Pl
Bronx, NY 10463
Phone (718) 694-9000

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

421 Route 59
Monsey, NY 10952
Phone (718) 694-9000

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": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1164670303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SEA CLIFF ST",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117521106",
            "telephone_number": "631-650-5964",
            "fax_number": "631-650-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 PARK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052735",
            "telephone_number": "718-963-0800",
            "fax_number": "718-534-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Sea Cliff St",
            "address_purpose": "LOCATION",
            "city": "Islip Terrace",
            "state": "NY",
            "postal_code": "117521106",
            "country_code": "US",
            "telephone_number": "631-650-5964",
            "fax_number": "631-650-5964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTON",
        "first_name": "PATTIE",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-29",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "400461-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334488-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.