Individual provider Active NPI

Sharon G. Coritsidis, RN, MSN, CPNP, CPON

  • Pediatric Nurse Practitioner
  • Mineola, NY
National Provider Identifier
1386893196
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F381497-1 Issued in NY
Practice address
120 Mineola Blvd
Suite 460
Mineola, NY 11501-4064
Phone
(516) 663-9400
Fax
(516) 663-9482
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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 F381497-1 NY Primary

Addresses

Primary practice location

120 Mineola Blvd
Suite 460
Mineola, NY 11501-4064

Mailing address

222 Station PLZ N
Suite 611
Mineola, NY 11501-3800
Phone (516) 663-2532

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scoritsidis308708@nyumc.direct-ci.com

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
I20110217000239 NY Practitioner - Nurse Practitioner 1557542024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F381497-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients

Locations

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

222 Station Plz N
Ste 611
Mineola, NY 11501
Phone (516) 663-2532

120 Mineola Blvd
Ste 460
Mineola, NY 11501
Phone (516) 663-9400

Networks

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

Interoperability endpoints

  • Direct secure messaging: scoritsidis308708@nyumc.direct-ci.com

Organizations & group practices 2

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1386893196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N",
            "address_2": "SUITE 611",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013800",
            "telephone_number": "516-663-2532",
            "fax_number": "516-663-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 460",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014064",
            "telephone_number": "516-663-9400",
            "fax_number": "516-663-9482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORITSIDIS",
        "first_name": "SHARON",
        "middle_name": "G.",
        "credential": "RN, MSN, CPNP, CPON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381497-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scoritsidis308708@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "120 Mineola Blvd",
            "address_2": "Suite 460",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.