Individual provider Active NPI

Andrea R Carson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Elmont, NY
National Provider Identifier
1356410542
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400189-1 Issued in NY
Practice address
570 Elmont Rd
Elmont, NY 11003-3535
Phone
(516) 437-6050
Fax
(516) 437-6304
NPI assigned
Nov 6, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F400189-1 NY Primary

Addresses

Primary practice location

570 Elmont Rd
Elmont, NY 11003-3535

Mailing address

570 Elmont Rd
Elmont, NY 11003-3535
Phone (516) 437-6050

Other identifiers 1

IdentifierTypeStateIssuer
F400189-1MedicaidNY

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
I20051220000499 NY Practitioner - Nurse Practitioner 1557383460 Reassigns benefits to 1 organization
Practice locations: Roslyn Heights, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Horizon Counseling Center IncGroup PAC ID 4880681295, 87 clinicians

Practice addresses (Care Compare)

108 -19 Rockaway Blvd
Ozone Park, NY 11420-1034

10819 Rockaway Blvd
South Ozone Park, NY 11420-1034
Phone (718) 845-2620

445 Oak St
Copiague, NY 11726-3111
Phone (631) 257-5173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F400189-1NYMDPsychiatric/Mental Health Nurse Practitioner

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, 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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356410542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 ELMONT RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033535",
            "telephone_number": "516-437-6050",
            "fax_number": "516-437-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 ELMONT RD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033535",
            "telephone_number": "516-437-6050",
            "fax_number": "516-437-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "ANDREA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400189-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F400189-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

Verify at the official NPI Registry.