Individual provider Active NPI

Nerisa Small

  • Adult Health Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1215332259
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F306723-1 Issued in NY
Practice address
125 Lake St Apt 7N-N
White Plains, NY 10604-2474
Phone
(914) 484-3222
NPI assigned
Nov 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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 F306723-1 NY Primary

Addresses

Primary practice location

125 Lake St Apt 7N-N
White Plains, NY 10604-2474

Mailing address

125 Lake St Apt 7N-N
White Plains, NY 10604-2474

Other practice location 1

199 Mount Eden Pkwy
Bronx, NY 10457-7703
Phone (718) 992-7669

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
I20250731001912 NY Practitioner - Nurse Practitioner 5496263659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

199 Mount Eden Pkwy
9 Health and Wellness Center
Bronx, NY 10457-7703
Phone (718) 901-8015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F306723-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince May 26, 2025 Accepting new patients
Bronxcare Health System CurrentSince May 26, 2025 Accepting new patients
Bronxcare Health System Past Accepting new patients

Locations

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

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

Organizations & group practices 3

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 1

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": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1215332259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 LAKE ST APT 7N-N",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LAKE ST APT 7N-N",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042474",
            "telephone_number": "914-484-3222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "199 Mount Eden Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577703",
            "country_code": "US",
            "telephone_number": "718-992-7669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALL",
        "first_name": "NERISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306723-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.