Petrina F. Ellis, APRN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F349223 Issued in NY

Practice address

30 S Broadway FL 2
Yonkers, NY 10701-3708

Phone

(914) 968-4898

Fax

(914) 968-1239

NPI assigned

Feb 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, NY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Vernon Neighborhood Health Center IncGroup PAC ID 0345139671, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

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.

• Mount Vernon Neighborhood Health Center Inc

  dba Mount Vernon Physician Group

  • Specialist
  • Mount Vernon, NY
  • NPI 1295912541
  Medicare reassignment Care Compare group NPD
• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855
  Medicare reassignment NPD
• Vocational Instruction Project Community Services, Inc.

  • Methadone Clinic
  • Bronx, NY
  • NPI 1881733830
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD
• Mount Vernon Neighborhood Health Center, Inc.

  dba Westchester Community Health Center Yonkers

  • Federally Qualified Health Center (FQHC)
  • Yonkers, NY
  • NPI 1952550055
  NPD
• Vocational Instruction Project Community Services Inc

  • Clinic/Center
  • Bronx, NY
  • NPI 1164880423
  NPD
• Mount Vernon Neighborhood Health Center, Inc.

  dba Westchester Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, NY
  • NPI 1396736120
  NPD (past)

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1356613574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S BROADWAY FL 2",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107013708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S BROADWAY FL 2",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107013708",
            "telephone_number": "914-968-4898",
            "fax_number": "914-968-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "PETRINA",
        "middle_name": "F.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-03",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "625326",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "F349223",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN253453",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F349223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Seton Pediatric Center (Elizabeth Seton Children's Center)
• Elizabeth Seton Pediatric Center (Elizabeth Seton Children's Center)
• Alaniz Elliott
• Katherine L Elliott, NP, RN
• Marcia Marie Ellis, LPN
• Deborah Pauline Elsenhout, LCSW
• Maria Emanuele, M.A., CCC-SLP
• Emergacare Ny LLC
• Emerging Vision Inc (sterling optical)
• Emerging Vision Inc.

• Family Nurse Practitioner in Yonkers, NY
• Providers in Yonkers, 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 Feb 12, 2025; 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.