Individual provider Active NPI

Vanessa Dutchin, NP

  • Adult Health Nurse Practitioner
  • Nyc, NY
National Provider Identifier
1184831224
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F 302834-1 Issued in NY
Practice address
560 First Ave
TH 183
Nyc, NY 10016
Phone
(212) 263-7411
NPI assigned
May 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F 302834-1 NY Primary

Addresses

Primary practice location

560 First Ave
TH 183
Nyc, NY 10016

Mailing address

103-07 29TH Ave, East Elmhurst
Queens, NY 11369
Phone (917) 656-6236

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
I20180605002753 NY Practitioner - Nurse Practitioner 3779705686 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F 302834-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 5, 2018 Accepting new patients
New York University CurrentSince Apr 5, 2018 Accepting new patients

Locations

560 1st Ave
#183
New York, NY 10016
Phone (212) 263-3960

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: vdutchin42282@nyumc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184831224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103-07 29TH AVE, EAST ELMHURST",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11369",
            "telephone_number": "917-656-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 FIRST AVE",
            "address_2": "TH 183",
            "city": "NYC",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-263-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTCHIN",
        "first_name": "VANESSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F 302834-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyc, NY

Sources for this page

Verify at the official NPI Registry.