Stephanie Marie Pichardo, CPNP-PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

383508 Issued in NY

Practice address

1411 Myrtle Ave
Brooklyn, NY 11237-4512

Phone

(718) 907-4301

NPI assigned

May 17, 2023

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 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.

• Wyckoff Professional Medical Services, PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1659710796

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1275224537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10415 35TH AVE APT 3F",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681972",
            "telephone_number": "347-701-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 MYRTLE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374512",
            "telephone_number": "718-907-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICHARDO",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "383508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Picerno
• Katherine Pichardo Burgos
• Martha Pichardo Gonzalez, MD
• Jissette Elena Pichardo
• Stephanie Pichardo, MHC
• David Pichkadze, MD
• Rimma Pichkar, D.O.
• Sandra Leigh Picillo
• Anila Piciri
• Avigayil Pick, BCBA

• Pediatrics Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.