Individual provider Active NPI

Nicholas Paul Lattanzio, NP

  • Adult Health Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1255819249
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308842 Issued in NY
Practice address
18036 80TH Dr
Jamaica, NY 11432-1532
Phone
(347) 277-4001
NPI assigned
Aug 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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 308842 NY Primary

Addresses

Primary practice location

18036 80TH Dr
Jamaica, NY 11432-1532

Mailing address

112 Wickham Rd
Garden City, NY 11530-2516
Phone (516) 322-4316

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
I20201103002027 NY Practitioner - Nurse Practitioner 9032529060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care for You PCGroup PAC ID 6800207879, 12 clinicians

Practice addresses (Care Compare)

Uniondale, NY 11556
Phone (718) 255-7368

Hospital & facility affiliations

  • VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008
  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • Extended Home Care Home health agency, Brooklyn, NY, CCN 337414

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas Lattanzio Nurse Practitioner in Adult Health PC Adult Health CurrentSince Aug 6, 2023 Accepting new patients
Excel Medical PC CurrentSince Aug 6, 2023 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Medical Care for You PC CurrentSince Aug 1, 2022 Accepting new patients

Locations

3200 Bronx Blvd
Bronx, NY 10467
Phone (718) 515-9807

1516 Oriental Blvd
Brooklyn, NY 11235
Phone (212) 342-9301

6711 164th St
Fresh Meadows, NY 11365
Phone (718) 762-4500

15 Saint Pauls Pl
Great Neck Plaza, NY 11021
Phone (516) 466-3001

130 Lake Ave S
Nesconset, NY 11767
Phone (631) 636-0620

211 Lake Shore Rd
Ronkonkoma, NY 11779
Phone (516) 581-1476

626 Rxr Plz
Uniondale, NY 11556
Phone (516) 280-9030

Networks

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

Organizations & group practices 4

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 4

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1255819249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WICKHAM RD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302516",
            "telephone_number": "516-322-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18036 80TH DR",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321532",
            "telephone_number": "347-277-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTANZIO",
        "first_name": "NICHOLAS",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.