Modise Elmine-Dautruche, MSN,NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

31176801 Issued in NY

Practice address

541 Clarkson Ave
Brooklyn, NY 11203

Phone

(718) 245-3480

Fax

(718) 245-5587

NPI assigned

Aug 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Networks

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

Interoperability endpoints

• Direct secure messaging: melmine1560162@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1316620214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "718-245-3480",
            "fax_number": "718-245-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMINE-DAUTRUCHE",
        "first_name": "MODISE",
        "name_prefix": "Mrs.",
        "credential": "MSN,NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2025-08-13",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "543061-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "31176801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maggie Elmardenly, DPT
• Randa Elmekki
• Hany Ahmed Elmeligy Sr., PT, DPT
• Khalid Mahamed Elmi, MD
• Sarah Elmi, M.D.
• Alourdes Elmine, RDH
• Lillian Elmirs, LMSW
• Ebrahim Elmohsen, DPT
• Elmont Imaging & Diagnostic
• Elmont Pharmacy Inc

• Adult Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, 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 Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.