Individual provider Active NPI

Bissoondai Persad, RN

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1174887731
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
652366-1 Issued in NY
Practice address
418 Ridgewood Ave
Brooklyn, NY 11208-1636
Phone
(718) 277-1964
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 652366-1 NY Primary

Addresses

Primary practice location

418 Ridgewood Ave
Brooklyn, NY 11208-1636

Mailing address

418 Ridgewood Ave
Brooklyn, NY 11208-1636
Phone (718) 277-1964

Other identifiers 1

IdentifierTypeStateIssuer
02386450MedicaidNY

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
652366-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Helpful Hand Agency Past Accepting new patients

Organizations & group practices 1

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1174887731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 RIDGEWOOD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112081636",
            "telephone_number": "718-277-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 RIDGEWOOD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112081636",
            "telephone_number": "718-277-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAD",
        "first_name": "BISSOONDAI",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "652366-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02386450",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.