SP Nurse Practitioner in Adult Health PC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SP NURSE PRACTITIONER IN ADULT HEALTH PC

Practice address

428 E Harrison St
Long Beach, NY 11561-2346

Phone

(212) 961-6767

NPI assigned

Oct 31, 2022

Last updated

Mar 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Seda Angelina Port, NPNPI 1447745278

Title

Owner

Phone

(212) 961-6767

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Seda Angelina Port, NP

  • Adult Health Nurse Practitioner
  • Long Beach, NY
  • NPI 1447745278

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Cristina Drumm, FNP, PMHNP

  • Family Nurse Practitioner
  • Carle Place, NY
  • NPI 1720542582

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1316654353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 E HARRISON ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612346",
            "telephone_number": "212-961-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 E HARRISON ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612346",
            "telephone_number": "212-961-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SP NURSE PRACTITIONER IN ADULT HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "PORT",
        "authorized_official_first_name": "SEDA",
        "authorized_official_middle_name": "ANGELINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-961-6767",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harish C Sood, MD
• Jeanine M Sorensen, PSY.D.
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• Karen Spadafora
• Maura Anne Spar
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• Psychiatric/Mental Health Nurse Practitioner in Long Beach, NY
• Providers in Long Beach, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.