Individual provider Active NPI

Martha Gustas, LPN

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1174904452
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
206380 Issued in NY
Practice address
85 Bartlett St
Brooklyn, NY 11206-4429
Phone
(171) 882-8266
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 206380 NY Primary

Addresses

Primary practice location

85 Bartlett St
Brooklyn, NY 11206-4429

Mailing address

14340 41St Ave Apt 5L
Flushing
Flushing, NY 11355-1829
Phone (917) 200-8870

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

State licenses

LicenseStateTypeSpecialty
206380NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1174904452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14340 41ST AVE APT 5L",
            "address_2": "FLUSHING",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551829",
            "telephone_number": "917-200-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BARTLETT ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064429",
            "telephone_number": "171-882-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAS",
        "first_name": "MARTHA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "206380",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 15, 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.