Individual provider Active NPI

Tessa Pieklik, WHNP

  • Women's Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1306317524
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
421345 Issued in NY
Practice address
40 Pinehurst Ave Ste CFB
New York, NY 10033-5529
Phone
(212) 923-8550
NPI assigned
Dec 16, 2018
Last updated
Nov 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 421345 NY Primary

Addresses

Primary practice location

40 Pinehurst Ave Ste CFB
New York, NY 10033-5529

Mailing address

675 W End Ave Apt 4C
New York, NY 10025-7366

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL n/a

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190416001158 NY Practitioner - Nurse Practitioner 5193066322 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
421345NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Manhatten Womens Health, an OB/GYN P.C. PastSince Nov 6, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1306317524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W END AVE APT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PINEHURST AVE STE CFB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100335529",
            "telephone_number": "212-923-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEKLIK",
        "first_name": "TESSA",
        "name_prefix": "Miss",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "421345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "40 Pinehurst Ave Ste Cfb",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100335529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.