Individual provider Active NPI

Donoveen Tulloch, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1184941858
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351379 Issued in NY
Practice address
174 E 51St St
Brooklyn, NY 11203-2302
Phone
(718) 671-2100
NPI assigned
Apr 21, 2010
Last updated
Feb 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 351379 NY Primary

Addresses

Primary practice location

174 E 51St St
Brooklyn, NY 11203-2302

Mailing address

1319 Remsen Ave
Brooklyn, NY 11236-4266
Phone (718) 671-2100

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
I20241213001739 NY Practitioner - Nurse Practitioner 4587190558 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Bay Ridge Medical Group, PLLCGroup PAC ID 0244677789, 10 clinicians

Practice addresses (Care Compare)

1456 Fulton St
Brooklyn, NY 11216-2505
Phone (718) 636-4500

7404 5TH Ave
Brooklyn, NY 11209-2704
Phone (929) 415-8856

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bedford Stuyvesant Family Health Center, Inc. Single Specialty CurrentSince Oct 6, 2025 Accepting new patients
Bay Ridge Medical Group, PLLC Single Specialty CurrentSince Sep 23, 2024 Accepting new patients
Bedford Stuyvesant Family Health Center, Inc. CurrentSince Oct 6, 2025 Accepting new patients

Locations

1238 Broadway
Brooklyn, NY 11221
Phone (718) 443-2428

1413 Fulton St
#0
Brooklyn, NY 11216

1456 Fulton St
Brooklyn, NY 11216
Phone (718) 636-4500

1722 Pitkin Ave
Brooklyn, NY 11212
Phone (929) 415-8856

7404 5th Ave
Brooklyn, NY 11209
Phone (929) 415-8856

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

803 Sterling Pl
Ste 205
Brooklyn, NY 11216

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFDFAA

Organizations & group practices 3

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": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1184941858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 REMSEN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364266",
            "telephone_number": "718-671-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 E 51ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032302",
            "telephone_number": "718-671-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLOCH",
        "first_name": "DONOVEEN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2023-02-22",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.