Individual provider Active NPI

Mae Cheryl Laborde

  • Adult Health Nurse Practitioner
  • East Stroudsburg, PA
National Provider Identifier
1366152811
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311094 Issued in NY
Practice address
136 Artist Trail LN
East Stroudsburg, PA 18301-8130
Phone
(570) 380-8242
NPI assigned
Nov 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311094 NY Primary

Addresses

Primary practice location

136 Artist Trail LN
East Stroudsburg, PA 18301-8130

Mailing address

136 Artist Trail LN
East Stroudsburg, PA 18301-8130
Phone (570) 380-8242

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
I20221219001937 NY Practitioner - Nurse Practitioner 0345619052 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
311094NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Medical Practice PC CurrentSince May 31, 2023 Accepting new patients
Medical Director Services PC CurrentSince Sep 1, 2022 Accepting new patients
JDS Medical Services PC CurrentSince Dec 9, 2025 Accepting new patients

Locations

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

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.

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1366152811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 ARTIST TRAIL LN",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018130",
            "telephone_number": "570-380-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 ARTIST TRAIL LN",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018130",
            "telephone_number": "570-380-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABORDE",
        "first_name": "MAE CHERYL",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.