Tszhoderrick Lum, DNP, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F338988 Issued in NY

Practice address

1424 Richmond Ave Ste C
Staten Island, NY 10314-1527

Phone

(718) 701-8103

Fax

(718) 701-8103

NPI assigned

Jul 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wellness Family Health NP, P.C.

  • Family Nurse Practitioner
  • Staten Island, NY
  • NPI 1841903192
  Medicare reassignment NPD Authorized official
• TSZ Ho Derrick Lum Family Health NP, P.C.

  • Primary Care Clinic/Center
  • Staten Island, NY
  • NPI 1174221584
  NPD Authorized official

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1346657103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 RICHMOND AVE STE C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141527",
            "telephone_number": "718-701-8103",
            "fax_number": "718-701-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 RICHMOND AVE STE C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141527",
            "telephone_number": "718-701-8103",
            "fax_number": "718-701-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUM",
        "first_name": "TSZHODERRICK",
        "name_prefix": "Dr.",
        "credential": "DNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R192541",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1034607",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338988",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171969",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04315519",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Luisi
• Jennifer Luistro-Pring, OTR/L
• Lukas Medical Corp
• Nafaika M Luke
• Elizabeth Lulaj, M.D.
• Luma Marriage and Family Therapy, PLLC
• Tarshea Sharrel Luma
• Ernest Lumer, LCSW
• Estelle Lumer, LCSW
• Nicole Luna

• Family Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.