Individual provider Active NPI

Victoria Marie Noonan, CPNP

  • Pediatric Nurse Practitioner
  • Garden City, NY
National Provider Identifier
1336629237
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F381407-1 Issued in NY
Practice address
123 Stratford Ave
Garden City, NY 11530-2631
Phone
(516) 248-3702
NPI assigned
Aug 20, 2018
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F381407-1 NY Primary

Addresses

Primary practice location

123 Stratford Ave
Garden City, NY 11530-2631

Mailing address

123 Stratford Ave
Garden City, NY 11530-2631
Phone (516) 248-3702

Other names 1

  • Victoria Marie Lamarca Former name

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
I20181207000208 NY Practitioner - Nurse Practitioner 0941544662 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F381407-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Nassau CurrentSince Mar 1, 2020 Accepting new patients
Mskcc Surgery Group CurrentSince Oct 26, 2018 Accepting new patients
Mskcc Regional Network CurrentSince Sep 15, 2024 Accepting new patients
Memorial Pediatric Group CurrentSince Sep 15, 2024 Accepting new patients

Locations

650 Commack Rd
Commack, NY 11725
Phone (631) 623-4000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1101 Hempstead Tpke
Uniondale, NY 11553
Phone (516) 559-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: vnoonan22505@mskcc.direct-ci.com

Organizations & group practices 4

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1336629237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 STRATFORD AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302631",
            "telephone_number": "516-248-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 STRATFORD AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302631",
            "telephone_number": "516-248-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "VICTORIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381407-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "LAMARCA",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.