Individual provider Active NPI

Farah Divers

  • Family Nurse Practitioner
  • Rosedale, NY
National Provider Identifier
1376057646
Registry record updated Nov 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F342209-1 Issued in NY
Practice address
25953 148TH Rd
Rosedale, NY 11422-2903
Phone
(917) 657-6511
NPI assigned
Nov 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2017

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 F342209-1 NY Primary

Addresses

Primary practice location

25953 148TH Rd
Rosedale, NY 11422-2903

Mailing address

25953 148TH Rd
Rosedale, NY 11422-2903

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
I20191112002104 NY Practitioner - Nurse Practitioner 5496187551 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F342209-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Current Accepting new patients
Harlem Medical Associates PC CurrentSince Sep 17, 2019 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Mar 1, 2020 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Mar 1, 2020 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

594 Albany Ave
Brooklyn, NY 11203
Phone (646) 694-6680

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Organizations & group practices 5

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": "1511568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511568000000",
    "number": "1376057646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25953 148TH RD",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25953 148TH RD",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222903",
            "telephone_number": "917-657-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVERS",
        "first_name": "FARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-25",
        "last_updated": "2017-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342209-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

Verify at the official NPI Registry.