Individual provider Active NPI

Christina Dephilips, FNP

  • General Acute Care Hospital
  • Staten Island, NY
National Provider Identifier
1174983738
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
340369 Issued in NY
Practice address
4143 Richmond Ave
Staten Island, NY 10312-5637
Phone
(718) 966-5556
NPI assigned
Feb 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 340369 NY Primary

Addresses

Primary practice location

4143 Richmond Ave
Staten Island, NY 10312-5637

Mailing address

11 Hemlock St
Staten Island, NY 10309-4288
Phone (917) 710-1352

Other identifiers 1

IdentifierTypeStateIssuer
340369MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170615002305 NY Practitioner - Nurse Practitioner 3577831585 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4295 Arthur Kill Rd
Suite 203
Staten Island, NY 10309-1343
Phone (929) 262-1255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Frank Scafuri III D.O.P,C CurrentSince Apr 18, 2017 Accepting new patients
Dr. Christina Dephilips. Nurse Practitioner in Family Health PLLC General Acute Care Hospital CurrentSince Jul 25, 2024 Accepting new patients

Locations

4295 Arthur Kill Rd
Ste 203
Staten Island, NY 10309
Phone (917) 710-1352

4143 Richmond Ave
Staten Island, NY 10312
Phone (718) 966-5556

2177 Victory Blvd
Staten Island, NY 10314
Phone (718) 370-3730

4143 Richmond Ave
Ste 1
Staten Island, NY 10312
Phone (718) 966-5556

682 Forest Ave
Staten Island, NY 10310
Phone (718) 370-3730

Organizations & group practices 2

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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1174983738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HEMLOCK ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103094288",
            "telephone_number": "917-710-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4143 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125637",
            "telephone_number": "718-966-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPHILIPS",
        "first_name": "CHRISTINA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "340369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340369",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.