Individual provider Active NPI

Joan Kershaw-Morris, NP-C

  • Family Nurse Practitioner
  • Long Island City, NY
National Provider Identifier
1255880480
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0341330 Issued in NY
Practice address
2101 41St Ave
Long Island City, NY 11101-4801
Phone
(718) 784-2240
NPI assigned
Sep 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AC001898 MD
Family Nurse Practitioner 363LF0000X LG-0000956 DE
Family Nurse Practitioner 363LF0000X 0341330 NY Primary

Addresses

Primary practice location

2101 41St Ave
Long Island City, NY 11101-4801

Mailing address

2101 41St Ave
Long Island City, NY 11101-4801
Phone (718) 784-2240

Other identifiers 1

IdentifierTypeStateIssuer
04999088MedicaidNY

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
I20180219001058 NY Practitioner - Nurse Practitioner 2264716240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Floating Hospital IncGroup PAC ID 0547367120, shared by 6 NPIs, 17 clinicians

Practice addresses (Care Compare)

2101 41St Ave
Long Island City, NY 11101-4801
Phone 7187842240144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LG-0000956DEMDFamily Nurse Practitioner
AC001898MDMDFamily Nurse Practitioner
0341330NYMDFamily Nurse Practitioner

Practice roles (5 of 8)

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
The Floating Hospital Inc. CurrentSince Nov 18, 2021 Accepting new patients
The Floating Hospital Inc. Current Accepting new patients
The Floating Hospital Inc. CurrentSince Dec 11, 2017 Accepting new patients
The Floating Hospital Inc. CurrentSince Dec 11, 2017 Accepting new patients

Locations

10875 Avenue D
Brooklyn, NY 11236
Phone (718) 257-2978

39 Auburn Pl
Brooklyn, NY 11205
Phone (718) 260-7682

2515 Queens Plz N
Long Island City, NY 11101
Phone 7187842240144

1029 41st Ave
Long Island City, NY 11101
Phone (718) 361-6266

2101 41st Ave
Long Island City, NY 11101
Phone (718) 691-6307

Networks

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

Interoperability endpoints

  • Direct secure messaging: joankershaw@mai.allscriptsdirect.net
  • Direct secure messaging: joan.kershaw.1@22829.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1255880480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 41ST AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014801",
            "telephone_number": "718-784-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 41ST AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014801",
            "telephone_number": "718-784-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHAW-MORRIS",
        "first_name": "JOAN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC001898",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000956",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "0341330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04999088",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.