Active NPI
Elizabeth Catherine Medina, FNP-BC MSN RN
- Family Nurse Practitioner
- Elmont, NY
National Provider Identifier
1386289007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F346807-01
- Practice address
- 1797 Dutch Broadway
Clinic #2061
Elmont, NY 11003-4243 - Phone
- (516) 561-1340
- NPI assigned
- Nov 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 679425 | NY | |
| Family Nurse Practitioner | 363LF0000X | F346807-01 | NY | Primary |
Addresses
Primary practice location
1797 Dutch Broadway
Clinic #2061
Elmont, NY 11003-4243
Mailing address
1797 Dutch Broadway # 2061
Elmont, NY 11003-4243
Phone (516) 561-1340
Other names 1
- Elizabeth Catherine Salandy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 679425 | NY | MD | Registered Nurse |
| F346807-01 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1574035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1386289007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1797 DUTCH BROADWAY # 2061",
"city": "ELMONT",
"state": "NY",
"postal_code": "110034243",
"telephone_number": "516-561-1340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1797 DUTCH BROADWAY",
"address_2": "CLINIC #2061",
"city": "ELMONT",
"state": "NY",
"postal_code": "110034243",
"telephone_number": "516-561-1340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "ELIZABETH",
"middle_name": "CATHERINE",
"credential": "FNP-BC MSN RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-18",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "679425",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F346807-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "SALANDY",
"middle_name": "CATHERINE",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Elmont, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.