Lora Lumubos Mamuyac, AGPCNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F307956-1 Issued in NY

Practice address

18 1St Ave
Holtsville, NY 11742-4208

Phone

(631) 902-8439

NPI assigned

Jun 22, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

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.

• Brookhaven Memorial Hospital Medical Center, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Patchogue, NY
  • NPI 1417232760
  Medicare reassignment NPD
• John T. Mather Memorial Hospital

  • Psychiatry Physician
  • Port Jefferson Station, NY
  • NPI 1376642371
  Medicare reassignment NPD
• Brookhaven Memorial Hospital Medical Center, Inc.

  • Physician Assistant
  • Patchogue, NY
  • NPI 1487843090
  NPD
• John T. Mather Memorial Hospital

  • Emergency Medicine Physician
  • Port Jefferson, NY
  • NPI 1104913748
  NPD
• John T. Mather Memorial Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
  • NPI 1467249334
  NPD
• Long Island Community Hospital at NYU Langone Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shirley, NY
  • NPI 1902029796
  NPD

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1275053142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 1ST AVE",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117424208",
            "telephone_number": "631-902-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 1ST AVE",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117424208",
            "telephone_number": "631-902-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMUYAC",
        "first_name": "LORA",
        "middle_name": "LUMUBOS",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307956-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Michelle Longo
• Lisamarie Loor
• Melissa Dawn Loubier, L.P.N.
• Charles Mahon, RN
• Jenny Maldonado
• Samuel C. Mann, DDS
• Amie Markowitz, LMSW
• Martino Physical Therapy, PC
• Andrew F Martino, PT
• Sharon A Martino, PHD/PT

• Adult Health Nurse Practitioner in Holtsville, NY
• Providers in Holtsville, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.