Individual provider Active NPI

Carli Pusateri

  • Registered Nurse
  • Lake Grove, NY
National Provider Identifier
1215404520
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
754893 Issued in NY
Practice address
18 Sterling Dr
Lake Grove, NY 11755-2321
Phone
(631) 838-0133
NPI assigned
Oct 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 754893 NY Primary

Addresses

Primary practice location

18 Sterling Dr
Lake Grove, NY 11755-2321

Mailing address

18 Sterling Dr
Lake Grove, NY 11755-2321

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
754893NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1215404520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 STERLING DR",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 STERLING DR",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552321",
            "telephone_number": "631-838-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSATERI",
        "first_name": "CARLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "754893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.