Individual provider Active NPI

Clover Smith, NP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1225041742
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F333634 Issued in NY
Practice address
339 Hicks St
Brooklyn, NY 11201-5509
Phone
(718) 780-1961
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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 F333634 NY Primary

Addresses

Primary practice location

339 Hicks St
Brooklyn, NY 11201-5509

Mailing address

339 Hicks St
Brooklyn, NY 11201-5509

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
I20040503000191 NY Practitioner - Nurse Practitioner 6507854320 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F333634NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Island Emergency Medical Services, P.C. CurrentSince Dec 1, 2019 Accepting new patients
Kingsbrook Medical Associates, PC Current Accepting new patients
Lich Faculty Practice Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
Long Island College Hospital Past Accepting new patients
Apollomd Group Services, LLC Past Accepting new patients

Locations

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

585 Schenectady Ave
#209
Brooklyn, NY 11203

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

Networks

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

Interoperability endpoints

  • Direct secure messaging: csmith2029871@nychhc.direct-ci.com

Organizations & group practices 6

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1225041742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 HICKS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 HICKS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015509",
            "telephone_number": "718-780-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLOVER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.