Individual provider Active NPI

Monika Jean Maclean, APRN

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1326565342
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308387 Issued in NY
Practice address
53 W 23Rd St FL 6
New York, NY 10010-4237
Phone
(212) 746-7159
Fax
(212) 746-7166
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 7159 CT
Gerontology Nurse Practitioner 363LG0600X 7159 CT
Gerontology Clinical Nurse Specialist 364SG0600X 308387 NY
Adult Health Nurse Practitioner 363LA2200X 308387 NY Primary

Addresses

Primary practice location

53 W 23Rd St FL 6
New York, NY 10010-4237

Mailing address

130 Bradhurst Ave Apt 702
New York, NY 10039-2438
Phone (917) 834-6978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170929003065 CT Practitioner - Nurse Practitioner 7810262896 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
308387NYMDLicensed Practical Nurse
7159CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South-West Community Health Center, Inc CurrentSince Aug 21, 2017 Accepting new patients

Locations

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

Networks

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

Interoperability endpoints

  • Direct secure messaging: okc9005@direct.nyp.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1326565342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BRADHURST AVE APT 702",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100392438",
            "telephone_number": "917-834-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W 23RD ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104237",
            "telephone_number": "212-746-7159",
            "fax_number": "212-746-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLEAN",
        "first_name": "MONIKA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "7159",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "7159",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "NY",
            "license": "308387",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.