Sea Wave NP Adult Health PC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

SEA WAVE NP ADULT HEALTH PC

Practice address

10 E 39TH St RM 914
New York, NY 10016-0111

Phone

(347) 389-2008

Fax

(877) 632-5925

NPI assigned

Mar 4, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Debra Blair

Title

Business Manager

Phone

(347) 693-5790

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wei Hong Xu

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1437587417
  Medicare reassignment NPD
• Radha Baum

  • Family Nurse Practitioner
  • New City, NY
  • NPI 1386977668
  NPD

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1295360725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 E 45TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112341430",
            "telephone_number": "347-693-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E 39TH ST RM 914",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160111",
            "telephone_number": "347-389-2008",
            "fax_number": "877-632-5925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9512 150th Rd",
            "address_purpose": "LOCATION",
            "city": "Ozone Park",
            "state": "NY",
            "postal_code": "114172919",
            "country_code": "US",
            "telephone_number": "347-389-2008",
            "fax_number": "877-632-5925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SEA WAVE NP ADULT HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "347-693-5790",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Alexander Scult, PHD
• Corey S Scurlock, M.D.
• Victoria Scurti
• SDK Physical and Occupational Therapy, PLLC
• Sea Change Ny
• Maria Seabaugh, DO
• Nola Michele Seader, OTR/L
• Merry Seaforth, CCC-SLP
• Carina Seah, MD PHD
• Sharon Seah

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, 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 Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.