Individual provider Active NPI

Demetria Deere, AGNP

  • Adult Health Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1194594176
Registry record updated Jan 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311336 Issued in NY
Practice address
1999 Marcus Ave Ste 308
New Hyde Park, NY 11042-1028
Phone
(516) 466-6611
NPI assigned
Jan 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2024

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 311336 NY Primary

Addresses

Primary practice location

1999 Marcus Ave Ste 308
New Hyde Park, NY 11042-1028

Mailing address

18 Brookline Dr
Massapequa, NY 11758-1814
Phone (516) 359-0378

Other names 1

  • Demetria Athenas 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
I20241203002917 NY Practitioner - Nurse Practitioner 4880129675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 26, 2024 Accepting new patients
New York University CurrentSince Sep 26, 2024 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

1999 Marcus Ave
Ste 308
New Hyde Park, NY 11042
Phone (516) 466-6611

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: ddeere308687@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 and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1704067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1194594176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 BROOKLINE DR",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581814",
            "telephone_number": "516-359-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 MARCUS AVE STE 308",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421028",
            "telephone_number": "516-466-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEERE",
        "first_name": "DEMETRIA",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-01",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEMETRIA",
            "last_name": "ATHENAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.