Individual provider Active NPI

Bobby Varghese, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Floral Park, NY
National Provider Identifier
1396018164
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F304483-1 Issued in NY
Practice address
8233 258TH St
Floral Park, NY 11004-1445
Phone
(718) 343-1494
NPI assigned
Feb 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F304483-1 NY Primary

Addresses

Primary practice location

8233 258TH St
Floral Park, NY 11004-1445

Mailing address

8233 258TH St
Floral Park, NY 11004-1445
Phone (718) 343-1494

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
I20200806002969 NY Practitioner - Nurse Practitioner 2365867488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 876-5555

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F304483-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients
North Shore - Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

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": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1396018164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8233 258TH ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041445",
            "telephone_number": "718-343-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8233 258TH ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041445",
            "telephone_number": "718-343-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "BOBBY",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304483-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

Verify at the official NPI Registry.