Individual provider Active NPI

Michelle Egoavil Solomos

  • Neonatal Nurse Practitioner
  • New York, NY
National Provider Identifier
1295425510
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
350576 Issued in NY
Practice address
1283 York Avenue
15TH FL
New York, NY 10065
Phone
(646) 697-6409
Fax
(646) 697-7800
NPI assigned
May 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neonatal Nurse Practitioner 363LN0000X 350576 NY Primary

Addresses

Primary practice location

1283 York Avenue
15TH FL
New York, NY 10065

Mailing address

182 Runnymede Rd
West Caldwell, NJ 07006-8117
Phone (908) 377-8773

Other practice location 1

182 Runnymede Rd
West Caldwell, NJ 07006-8117
Phone (908) 377-8773

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
350576NYMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1295425510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 RUNNYMEDE RD",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070068117",
            "telephone_number": "908-377-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 YORK AVENUE",
            "address_2": "15TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "646-697-6409",
            "fax_number": "646-697-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "182 Runnymede Rd",
            "address_purpose": "LOCATION",
            "city": "West Caldwell",
            "state": "NJ",
            "postal_code": "070068117",
            "country_code": "US",
            "telephone_number": "908-377-8773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMOS",
        "first_name": "MICHELLE",
        "middle_name": "EGOAVIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NY",
            "license": "350576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.