Individual provider Active NPI

Lizzette Canales-Rangel

  • Licensed Practical Nurse
  • Bay Shore, NY
National Provider Identifier
1245842871
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
332416 Issued in NY
Practice address
87 California Ave
Bay Shore, NY 11706-4503
Phone
(347) 777-9204
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 332416 NY Primary
Licensed Practical Nurse 164W00000X 3324161 NY

Addresses

Primary practice location

87 California Ave
Bay Shore, NY 11706-4503

Mailing address

87 California Ave
Bay Shore, NY 11706-4503
Phone (347) 777-9204

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

State licenses

LicenseStateTypeSpecialty
332416NYMDLicensed Practical Nurse
3324161NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1245842871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 CALIFORNIA AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064503",
            "telephone_number": "347-777-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 CALIFORNIA AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064503",
            "telephone_number": "347-777-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANALES-RANGEL",
        "first_name": "LIZZETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "332416",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "3324161",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.