Individual provider Active NPI

Melissa Vergara, AGNP-BC

  • Adult Health Nurse Practitioner
  • Levittown, NY
National Provider Identifier
1235721333
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309809 Issued in NY
Practice address
50 Blacksmith Rd
Levittown, NY 11756-3115
Phone
(917) 536-1944
NPI assigned
Feb 9, 2021
Last updated
Feb 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F309809 NY Primary

Addresses

Primary practice location

50 Blacksmith Rd
Levittown, NY 11756-3115

Mailing address

50 Blacksmith Rd
Levittown, NY 11756-3115
Phone (917) 536-1944

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
I20210719000146 NY Practitioner - Nurse Practitioner 3072915735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F309809NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prine Health Medical Group, PLLC CurrentSince Oct 26, 2022 Accepting new patients
Prine Health Medical Group, PLLC CurrentSince Oct 26, 2022 Accepting new patients

Locations

155 W Merrick Rd
Ste 202
Freeport, NY 11520
Phone (516) 546-2448

370 Old Country Rd
Ste 100
Garden City, NY 11530
Phone (516) 222-1000

1129 Northern Blvd
Ste 101
Manhasset, NY 11030
Phone (516) 365-5570

Networks

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

Interoperability endpoints

  • Direct secure messaging: melissavergara@nslijmedgr.allscriptsdirect.net

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": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1235721333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BLACKSMITH RD",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563115",
            "telephone_number": "917-536-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BLACKSMITH RD",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563115",
            "telephone_number": "917-536-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "MELISSA",
        "credential": "AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

Verify at the official NPI Registry.