Individual provider Active NPI

Laurie Yuditsky, RN, MBA, BSN

  • Home Health Registered Nurse
  • Smithtown, NY
National Provider Identifier
1316579980
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
484112-01 Issued in NY
Practice address
17 Bank Ave
Smithtown, NY 11787-2703
Phone
(631) 265-5300
Fax
(631) 265-5789
NPI assigned
Feb 11, 2020
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 484112-01 NY Primary

Addresses

Primary practice location

17 Bank Ave
Smithtown, NY 11787-2703

Mailing address

5 Cliftwood PL
Kings Park, NY 11754-4010
Phone (516) 532-0713

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
Credentials
Bachelor on Science - Nursing, Master of Business Administration, Registered Nurse

State licenses

LicenseStateTypeSpecialty
484112-01NYMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Nursing Registry, Inc. CurrentSince Dec 6, 2020 Accepting new patients

Locations

17 Bank Ave
Smithtown, NY 11787
Phone (631) 261-3629

Organizations & group practices 1

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": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1316579980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CLIFTWOOD PL",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117544010",
            "telephone_number": "516-532-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BANK AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872703",
            "telephone_number": "631-265-5300",
            "fax_number": "631-265-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUDITSKY",
        "first_name": "LAURIE",
        "credential": "RN, MBA, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "484112-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.