Individual provider Active NPI

Theresa Pinson, N.P.

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1215943188
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
334906 Issued in NY
Practice address
65 Broadway Ste 1804
New York, NY 10006-2560
Phone
(212) 430-6677
Fax
(212) 430-6678
NPI assigned
Jul 31, 2006
Last updated
Feb 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 334906 NY Primary

Addresses

Primary practice location

65 Broadway Ste 1804
New York, NY 10006-2560

Mailing address

5 Eagle Chase
Woodbury, NY 11797-2900
Phone (212) 430-6677

Other identifiers 1

IdentifierTypeStateIssuer
02754956MedicaidNY

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
334906NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ageless Men's Health, Ca, PC Past Accepting new patients
Ageless Men's Health Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1215943188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 EAGLE CHASE",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972900",
            "telephone_number": "212-430-6677",
            "fax_number": "212-430-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BROADWAY STE 1804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062560",
            "telephone_number": "212-430-6677",
            "fax_number": "212-430-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINSON",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "334906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02754956",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.