Individual provider Active NPI

Merisa Bajraktarevic, FNP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1285428086
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
356519 Issued in NY
Practice address
54 Livermore Ave
Staten Island, NY 10302-2503
Phone
(917) 960-0051
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 356519 NY Primary

Addresses

Primary practice location

54 Livermore Ave
Staten Island, NY 10302-2503

Mailing address

54 Livermore Ave
Staten Island, NY 10302-2503
Phone (917) 960-0051

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

State licenses

LicenseStateTypeSpecialty
356519NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1285428086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 LIVERMORE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022503",
            "telephone_number": "917-960-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 LIVERMORE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022503",
            "telephone_number": "917-960-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJRAKTAREVIC",
        "first_name": "MERISA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "356519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.