Active NPI
Susanjohnna Sciametta, R.N.
- Registered Nurse
- Lake Grove, NY
National Provider Identifier
1285075465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 593391-1
- Practice address
- 3 Williams Blvd
Apart. 1B
Lake Grove, NY 11755-2447 - Phone
- (631) 327-2455
- NPI assigned
- Jul 16, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 593391-1 | NY | Primary |
Addresses
Primary practice location
3 Williams Blvd
Apart. 1B
Lake Grove, NY 11755-2447
Mailing address
3 Williams Blvd
Apart. 1B
Lake Grove, NY 11755-2447
Phone (631) 327-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 593391-1 | Medicaid | NY |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 593391-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1285075465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 WILLIAMS BLVD",
"address_2": "APART. 1B",
"city": "LAKE GROVE",
"state": "NY",
"postal_code": "117552447",
"telephone_number": "631-327-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 WILLIAMS BLVD",
"address_2": "APART. 1B",
"city": "LAKE GROVE",
"state": "NY",
"postal_code": "117552447",
"telephone_number": "631-327-2455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCIAMETTA",
"first_name": "SUSANJOHNNA",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-16",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "593391-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "593391-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Grove, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.