Organization Active NPI

Vital Care NP in Family Health PLLC

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1194617787
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
VITAL CARE NP IN FAMILY HEALTH PLLC
Practice address
14736 76TH Ave
Flushing, NY 11367-3118
Phone
(646) 525-5965
NPI assigned
Jul 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Authorized official

Name
Mrs. Rivka Fenton
Title
Credentialing Specialist
Phone
(224) 491-2517

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

14736 76TH Ave
Flushing, NY 11367-3118

Mailing address

14736 76TH Ave
Flushing, NY 11367-3118
Phone (646) 525-5965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260204000879 NY Part B Supplier - Clinic/Group Practice 5193203750 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1194617787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14736 76TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673118",
            "telephone_number": "646-525-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14736 76TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673118",
            "telephone_number": "646-525-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL CARE NP IN FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-17",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "FENTON",
        "authorized_official_first_name": "RIVKA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "224-491-2517",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.