Individual provider Active NPI

Miguel Angel Pina Jr., FNP

  • Family Nurse Practitioner
  • Mount Vernon, NY
National Provider Identifier
1205511219
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
352252 Issued in NY
Practice address
107 W 4TH St
Mount Vernon, NY 10550-4002
Phone
(914) 699-7200
NPI assigned
Jun 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 352252 NY Primary

Addresses

Primary practice location

107 W 4TH St
Mount Vernon, NY 10550-4002

Mailing address

107 W 4TH St
Mount Vernon, NY 10550-4002

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
I20230908002526 NY Practitioner - Nurse Practitioner 9133583123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Vernon Neighborhood Health Center IncGroup PAC ID 0345139671, 48 clinicians

Practice addresses (Care Compare)

107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MP Family Health NP PLLC Family CurrentSince Dec 7, 2025 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Jul 24, 2023 Accepting new patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Jul 24, 2023 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. Past Accepting new patients

Locations

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

295 Knollwood Rd
White Plains, NY 10607
Phone (914) 699-7200

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1205511219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINA",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.