NPIMap

Individual provider Active NPI

Pauline Kuriakose

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1265911648
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
431369 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-2000
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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 431369 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

3050 21St St Apt 6J
Astoria, NY 11102-2877
Phone (602) 471-3643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213000224 NY Practitioner - Nurse Practitioner 3779821012 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Clinical Physiology GroupGroup PAC ID 3678464716, 12 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Anesthesiology Group CurrentSince Dec 26, 2018 Accepting new patients
Memorial Clinical Physiology Group CurrentSince Mar 1, 2020 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Jan 15, 2022 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Jan 15, 2022 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Oct 13, 2019 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Oct 13, 2019 Accepting new patients
Essen Medical Associates, PC CurrentSince Jan 15, 2022 Accepting new patients
Memorial Solid Tumor Group CurrentSince Oct 13, 2019 Accepting new patients
Essen Medical Associates, PC CurrentSince Jan 15, 2022 Accepting new patients
Memorial Pulmonary Function Group Past Accepting new patients

Locations

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: pkuriakose41698@mskcc.direct-ci.com

Organizations & group practices 10

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": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1265911648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 21ST ST APT 6J",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022877",
            "telephone_number": "602-471-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "PAULINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.