Individual provider Active NPI

Mirelle Jumeau, RN,BSN,CVRN,BC

  • Home Health Agency
  • Elmont, NY
National Provider Identifier
1265188015
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
661330-1 Issued in NY
Practice address
479 Hempstead Tpke Ste C
Elmont, NY 11003-1602
Phone
(516) 395-1073
Fax
(516) 544-6621
NPI assigned
Mar 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 6613301 NY
Nursing Home AdministratorGroup: 193200000X MULTI-SPECIALTY GROUP 376G00000X 6613301 NY
Home Health Agency 251E00000X 661330-1 NY Primary

Addresses

Primary practice location

479 Hempstead Tpke Ste C
Elmont, NY 11003-1602

Mailing address

479 Hempstead Tpke Ste C
Elmont, NY 11003-1602
Phone (516) 395-1073

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
661330-1NYMDHome Health Agency
6613301NYMDNursing Home Administrator

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1265188015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 HEMPSTEAD TPKE STE C",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031602",
            "telephone_number": "516-395-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 HEMPSTEAD TPKE STE C",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031602",
            "telephone_number": "516-395-1073",
            "fax_number": "516-544-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMEAU",
        "first_name": "MIRELLE",
        "credential": "RN,BSN,CVRN,BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "6613301",
            "primary": false
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nursing Home Administrator",
            "state": "NY",
            "license": "6613301",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "661330-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.