Individual provider Active NPI

Brittany Catherine Callahan, NP

  • Pediatric Nurse Practitioner
  • Selden, NY
National Provider Identifier
1386426807
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383599 Issued in NY
Practice address
239 Middle Country Rd
Selden, NY 11784-2516
Phone
(631) 696-5437
NPI assigned
Oct 18, 2023
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 383599 NY Primary

Addresses

Primary practice location

239 Middle Country Rd
Selden, NY 11784-2516

Mailing address

62 Huron St
Port Jefferson Station, NY 11776-4338

Other practice location 1

5050 Sunrise Hwy
Massapequa Park, NY 11762-2928
Phone (516) 541-5437

Other practice location 2

1130 Deer Park Ave
North Babylon, NY 11703-3102
Phone (631) 667-4767

Other practice location 3

6218 Jericho Tpke
Commack, NY 11725-2801
Phone (631) 499-5437

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
383599NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PM Pediatrics of Mamaroneck Past Accepting new patients
PM Pediatrics PC Past Accepting new patients
PM Pediatrics of Selden PastSince Oct 22, 2023 Accepting new patients
PM Pediatrics of Selden Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1386426807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 HURON ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 MIDDLE COUNTRY RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117842516",
            "telephone_number": "631-696-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5050 Sunrise Hwy",
            "address_purpose": "LOCATION",
            "city": "Massapequa Park",
            "state": "NY",
            "postal_code": "117622928",
            "country_code": "US",
            "telephone_number": "516-541-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 Deer Park Ave",
            "address_purpose": "LOCATION",
            "city": "North Babylon",
            "state": "NY",
            "postal_code": "117033102",
            "country_code": "US",
            "telephone_number": "631-667-4767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6218 Jericho Tpke",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117252801",
            "country_code": "US",
            "telephone_number": "631-499-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "BRITTANY",
        "middle_name": "CATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selden, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.