NPIMap

Individual provider Active NPI

Alyssa Nicole Venezia, FNP

  • Family Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1366042764
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346411 Issued in NY
Practice address
1320 Stony Brook Rd Ste 100
Stony Brook, NY 11790-2222
Phone
(631) 941-2273
NPI assigned
Oct 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 346411 NY Primary

Addresses

Primary practice location

1320 Stony Brook Rd Ste 100
Stony Brook, NY 11790-2222

Mailing address

1320 Stony Brook Rd Ste 100
Stony Brook, NY 11790-2222
Phone (631) 941-2273

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alyssa.venezia@sbcm.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210114002062 NY Practitioner - Nurse Practitioner 5092128900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
346411NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Nov 23, 2020 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation PastSince Nov 1, 2020 Accepting new patients
Cardiac Ekg Interpretation, P. C. PastSince Nov 1, 2020 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

1320 Stony Brook Rd
Bldg D100
Stony Brook, NY 11790
Phone (631) 941-2273

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: alyssa.venezia@sbcm.cernerdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1366042764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 STONY BROOK RD STE 100",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902222",
            "telephone_number": "631-941-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 STONY BROOK RD STE 100",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902222",
            "telephone_number": "631-941-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEZIA",
        "first_name": "ALYSSA",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alyssa.venezia@sbcm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1320 Stony Brook Rd Ste 100",
            "city": "Stony Brook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117902222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.