NPIMap

Organization Active NPI

Primary Care NP in Family Health and Adult Health of New York PLLC

Doing business as Primary Care Nurse Practitioners of New York

  • Primary Care Clinic/Center
  • Staten Island, NY
National Provider Identifier
1194975524
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PRIMARY CARE NP IN FAMILY HEALTH AND ADULT HEALTH OF NEW YORK PLLC
Doing business as
Primary Care Nurse Practitioners of New York
Practice address
130 Rose Ave
Staten Island, NY 10306-2241
Phone
(718) 980-1553
NPI assigned
Sep 22, 2008
Last updated
Feb 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Authorized official

Name
Mrs. Virginia Nelson, NP
Title
Owner
Phone
(718) 980-1553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

130 Rose Ave
Staten Island, NY 10306-2241

Mailing address

130 Rose Ave
Staten Island, NY 10306-2241
Phone (718) 980-1553

Other identifiers 2

IdentifierTypeStateIssuer
03129513MedicaidNY
A100000571OtherNYMEDICARE PTAN

Other names 1

  • Primary Care Nurse Practitioners of New York Doing business as

National Provider Directory

National Provider Directory

Locations

130 Rose Ave
Staten Island, NY 10306
Phone (718) 980-1553

97 New Dorp Ln
#D
Staten Island, NY 10306
Phone (718) 980-1553

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1194975524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ROSE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062241",
            "telephone_number": "718-980-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 ROSE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062241",
            "telephone_number": "718-980-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE NP IN FAMILY HEALTH AND ADULT HEALTH OF NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-980-1553",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03129513",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A100000571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Nurse Practitioners of New York",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.