Individual provider Active NPI

Susanne Rendeiro, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1306865696
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F331714 Issued in NY
Practice address
400 Broadway
New York, NY 10013-3698
Phone
(212) 334-6029
Fax
(212) 334-7957
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X F331714 NY
Family Nurse Practitioner 363LF0000X F331714 NY Primary

Addresses

Primary practice location

400 Broadway
New York, NY 10013-3698

Mailing address

400 Broadway
New York, NY 10013-3698
Phone (212) 334-6029

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
I20120420000491 NY Practitioner - Nurse Practitioner 0446411250 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F331714NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apicha Community Health Center Current Accepting new patients
Apicha Community Health Center CurrentSince Mar 19, 2012 Accepting new patients

Locations

8211 37th Ave
Jackson Heights, NY 11372
Phone (646) 747-8091

400 Broadway
Fl 4
New York, NY 10013
Phone (212) 334-6029

400 Broadway
New York, NY 10013
Phone (212) 334-6029

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJBGAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1306865696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133698",
            "telephone_number": "212-334-6029",
            "fax_number": "212-334-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133698",
            "telephone_number": "212-334-6029",
            "fax_number": "212-334-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDEIRO",
        "first_name": "SUSANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "F331714",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.