Individual provider Active NPI

Maritza Monserrat, LPN

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1346614955
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
175166-1 Issued in NY
Practice address
880 Morris Ave
Bronx, NY 10451-3412
Phone
(718) 665-9340
Fax
(718) 665-2394
NPI assigned
Nov 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 175166-1 NY Primary

Addresses

Primary practice location

880 Morris Ave
Bronx, NY 10451-3412

Mailing address

880 Morris Ave
Bronx, NY 10451-3412
Phone (718) 665-9340

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

State licenses

LicenseStateTypeSpecialty
175166-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Icon Medical, PLLC Current Accepting new patients
Concourse Medical Center Inc Past Accepting new patients

Organizations & group practices 2

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": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1346614955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 MORRIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513412",
            "telephone_number": "718-665-9340",
            "fax_number": "718-665-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 MORRIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513412",
            "telephone_number": "718-665-9340",
            "fax_number": "718-665-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONSERRAT",
        "first_name": "MARITZA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "175166-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.