Individual provider Active NPI

Monique C. Luckett-Cummings, FNP

  • Nurse Practitioner
  • Valhalla, NY
National Provider Identifier
1205418753
Registry record updated Dec 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
348196 Issued in NY
Practice address
10 Woods Rd
Valhalla, NY 10595-1529
Phone
(917) 371-8441
Fax
(914) 231-1203
NPI assigned
Apr 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Continuing Education/Staff Development Registered Nurse 163WC1600X 658951 NY
Family Nurse Practitioner 363LF0000X 658951 NY
Nurse Practitioner 363L00000X 348196 NY Primary

Addresses

Primary practice location

10 Woods Rd
Valhalla, NY 10595-1529

Mailing address

3650 Varian Ave
Bronx, NY 10466-5935
Phone (917) 371-8441

Other practice location 1

3650 Varian Ave
Bronx, NY 10466-5935
Phone (917) 371-8441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
348196NYMDNurse Practitioner
658951NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639267200000",
    "number": "1205418753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 VARIAN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104665935",
            "telephone_number": "917-371-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951529",
            "telephone_number": "917-371-8441",
            "fax_number": "914-231-1203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3650 Varian Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104665935",
            "country_code": "US",
            "telephone_number": "917-371-8441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCKETT-CUMMINGS",
        "first_name": "MONIQUE",
        "middle_name": "C.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-24",
        "last_updated": "2021-12-12",
        "certification_date": "2021-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "NY",
            "license": "658951",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "658951",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "348196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2021; 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.