Individual provider Active NPI

Phedre Phara Paulemon, MSN, APRN, FNP-C

  • Primary Care Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1376748558
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
343011 Issued in NY
Practice address
375 Linden Blvd
Brooklyn, NY 11203-2709
Phone
(917) 907-0797
Fax
(718) 540-8678
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12.0095564 CT
Family Nurse Practitioner 363LF0000X 2598428 FL
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 343011 NY
Primary Care Nurse Practitioner 363LP2300X 343011 NY Primary

Addresses

Primary practice location

375 Linden Blvd
Brooklyn, NY 11203-2709

Mailing address

2525 Nostrand Ave Apt 2C
Brooklyn, NY 11210-4715
Phone (954) 867-6982

Other practice location 1

2525 Nostrand Ave Apt 2C
Brooklyn, NY 11210-4715
Phone (917) 907-0797

Other practice location 2

2601 OCEAN Pkwy
Pagny
Brooklyn, NY 11235
Phone (718) 616-5500

Other identifiers 6

IdentifierTypeStateIssuer
05401478MedicaidNY
241008000231OtherNYFIDELIS
0798935OtherNYCIGNA
P0569292OtherNYELDERPLAN
3886122OtherNYAETNA
F343011-CIDOtherNYHEALTHFIRST

Other names 1

  • Ms. Phara Paulemon Other name

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
I20190116003271 NY Practitioner - Nurse Practitioner 6507102241 Reassigns benefits to 3 organizations
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians
New York City Health and Hospitals CorporationGroup PAC ID 4183535305, 543 clinicians

Practice addresses (Care Compare)

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

594 Albany Ave
Brooklyn, NY 11203-1706
Phone (646) 694-6680

Hospital & facility affiliations

  • South Brooklyn Health Hospital, Brooklyn, NY, CCN 330196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12.0095564CTMDFamily Nurse Practitioner
2598428FLMDFamily Nurse Practitioner
343011NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitals Healthcare SVCS Single Specialty CurrentSince May 1, 2022 Accepting new patients
Coney Island Medical Practice Plan, P.C. Single Specialty CurrentSince Nov 18, 2018 Accepting new patients
Physician Affiliate Group of New York PC Single Specialty CurrentSince Nov 14, 2024 Accepting new patients
New York City Health and Hospitals Corporation Single Specialty CurrentSince Sep 4, 2025 Accepting new patients
New York City Health and Hospitals Corporation Single Specialty Current Accepting new patients
Vitals Healthcare SVCS Single Specialty CurrentSince May 1, 2022 Accepting new patients

Locations

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

2925 W 19th St
Brooklyn, NY 11224
Phone (718) 616-6034

2601 Ocean Pkwy
Rm 3N17
Brooklyn, NY 11235
Phone (718) 616-4554

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

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

Interoperability endpoints

  • Direct secure messaging: ppaulemon557233@nychhc.direct-ci.com

Organizations & group practices 6

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 1

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1376748558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 NOSTRAND AVE APT 2C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112104715",
            "telephone_number": "954-867-6982",
            "fax_number": "917-933-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032709",
            "telephone_number": "917-907-0797",
            "fax_number": "718-540-8678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Nostrand Ave Apt 2C",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112104715",
            "country_code": "US",
            "telephone_number": "917-907-0797",
            "fax_number": "917-933-4212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 OCEAN Pkwy",
            "address_2": "PAGNY",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11235",
            "country_code": "US",
            "telephone_number": "718-616-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAULEMON",
        "first_name": "PHEDRE",
        "middle_name": "PHARA",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.0095564",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2598428",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343011",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "343011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05401478",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "241008000231",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0798935",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERPLAN",
            "identifier": "P0569292",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3886122",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHFIRST",
            "identifier": "F343011-CID",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHARA",
            "last_name": "PAULEMON",
            "prefix": "MS.",
            "credential": "RN, NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.