Individual provider Active NPI

Camille Lynn Lineberry, RN, ACNP-BC

  • Acute Care Nurse Practitioner
  • Commack, NY
National Provider Identifier
1255500625
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
430393 Issued in NY
Practice address
650 Commack Rd
Commack, NY 11725-5404
Phone
(631) 636-0590
NPI assigned
Feb 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 430393 NY Primary

Addresses

Primary practice location

650 Commack Rd
Commack, NY 11725-5404

Mailing address

650 Commack Rd
Commack, NY 11725-5404
Phone (631) 636-0590

Other practice location 1

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-7555

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
I20090826000678 NY Practitioner - Nurse Practitioner 4789739764 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK NassauGroup PAC ID 8628311685, 100 clinicians
MSK HarrisonGroup PAC ID 1052634045, 134 clinicians
Mskcc Regional NetworkGroup PAC ID 6608765144, 130 clinicians

Practice addresses (Care Compare)

1101 Hempstead Tpke
Uniondale, NY 11553-1112
Phone (212) 639-2000

500 Westchester Ave
West Harrison, NY 10604-3200
Phone (212) 639-2000

650 Commack Rd
Commack, NY 11725-5404
Phone (631) 623-4034

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Current Accepting new patients
MSK Nassau CurrentSince Sep 1, 2024 Accepting new patients
MSK Harrison CurrentSince Sep 1, 2024 Accepting new patients
Memorial Anesthesiology Group CurrentSince Aug 1, 2009 Accepting new patients
Mskcc Regional Network CurrentSince Sep 1, 2024 Accepting new patients
Memorial Urgent Care Group CurrentSince Sep 1, 2024 Accepting new patients

Locations

650 Commack Rd
Commack, NY 11725
Phone (631) 623-4000

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

1101 Hempstead Tpke
Uniondale, NY 11553
Phone (516) 559-1000

500 Westchester Ave
West Harrison, NY 10604
Phone (914) 367-7000

Networks

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

Interoperability endpoints

  • Direct secure messaging: clineberry96218@mskcc.direct-ci.com
  • Direct secure messaging: camille.lineberry@direct.stonybrookmedicine.edu

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1255500625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255404",
            "telephone_number": "631-636-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255404",
            "telephone_number": "631-636-0590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "212-639-7555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINEBERRY",
        "first_name": "CAMILLE",
        "middle_name": "LYNN",
        "credential": "RN, ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.