Individual provider Active NPI

Nohely Yarassell Uribe, NP

  • Family Nurse Practitioner
  • Corona, NY
National Provider Identifier
1184456378
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355002 Issued in NY
Practice address
10211 Roosevelt Ave
Corona, NY 11368-2331
Phone
(718) 898-5200
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355002 NY Primary

Addresses

Primary practice location

10211 Roosevelt Ave
Corona, NY 11368-2331

Mailing address

10211 Roosevelt Ave Ste 4
Corona, NY 11368-2331

Other names 1

  • Nohely Yarassell Uribe Boya Former name

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
I20251210001296 NY Order and Referring Only - Nurse Practitioner 8022502889

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
355002NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sop Medical PC CurrentSince Oct 27, 2024 Accepting new patients

Locations

10211 Roosevelt Ave
Ste 4
Corona, NY 11368
Phone (718) 898-1386

10211 Roosevelt Ave
Corona, NY 11368
Phone (718) 898-5200

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1184456378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10211 ROOSEVELT AVE STE 4",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682331",
            "telephone_number": "718-898-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URIBE",
        "first_name": "NOHELY",
        "middle_name": "YARASSELL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOHELY",
            "last_name": "URIBE BOYA",
            "middle_name": "YARASSELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corona, NY

Sources for this page

Verify at the official NPI Registry.