Individual provider Active NPI

Rachel Maouyo, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1215484415
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F351225 Issued in NY
Practice address
200 W 57TH St Ste 1300
New York, NY 10019-3225
Phone
(212) 523-7570
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F351225 NY Primary
Registered Nurse 163W00000X 701566 NY

Addresses

Primary practice location

200 W 57TH St Ste 1300
New York, NY 10019-3225

Mailing address

4857 Broadway Apt 5D
New York, NY 10034-3176
Phone (603) 568-4154

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
I20240605003134 NY Practitioner - Nurse Practitioner 7911449913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W 57TH St
W
New York, NY 10019-3211
Phone (212) 603-4160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
701566NYMDRegistered Nurse
F351225NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 29, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 29, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

200 W 57th St
New York, NY 10019
Phone (212) 247-8100

200 W 57th St
Ste 1300
New York, NY 10019
Phone (212) 523-6333

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

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.

NPI Registry JSON

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1215484415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4857 BROADWAY APT 5D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343176",
            "telephone_number": "603-568-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 57TH ST STE 1300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193225",
            "telephone_number": "212-523-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAOUYO",
        "first_name": "RACHEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F351225",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "701566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.