Active NPI
Nicolas Cerniglia
- Psychiatric/Mental Health Nurse Practitioner
- Port Jefferson Station, NY
National Provider Identifier
1235504853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 401122
- Practice address
- 55 Nesconset Hwy
Port Jefferson Station, NY 11776-2631 - Phone
- (631) 474-8099
- NPI assigned
- Dec 8, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 401122 | NY | Primary |
Addresses
Primary practice location
55 Nesconset Hwy
Port Jefferson Station, NY 11776-2631
Mailing address
55 Nesconset Hwy
Port Jefferson Station, NY 11776-2631
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- State University of New York at Stony Brook, School of Medicine, 2007
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
55 Nesconset Hwy
Suite 1
Port Jefferson Station, NY 11776-2631
Phone (631) 474-8099
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 401122 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Organizations & group practices 1
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.
-
- Cognitive & Behavioral Psychologist
- Port Jefferson, NY
- NPI 1609249754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514505600000",
"number": "1235504853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 NESCONSET HWY",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117762631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 NESCONSET HWY",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117762631",
"telephone_number": "631-474-8099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERNIGLIA",
"first_name": "NICOLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-08",
"last_updated": "2017-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "401122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.