Individual provider Active NPI

Xiomara M. Dorrejo, AGPCNP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1396253290
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308282-1 Issued in NY
Practice address
19 E 98TH St Ste 4
New York, NY 10029-6501
Phone
(212) 241-1101
NPI assigned
Jan 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 308282-1 NY Primary

Addresses

Primary practice location

19 E 98TH St Ste 4
New York, NY 10029-6501

Mailing address

One Gustave L. Levy Place
Box 1070
New York, NY 10029

Other practice location 1

19 E 98th St Ste 4
New York, NY 10029-6501
Phone (212) 241-1101

Other practice location 2

19 E 98th St Ste 4
New York, NY 10029-6501
Phone (212) 241-1101

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
I20180807003824 NY Practitioner - Nurse Practitioner 2466700430 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
308282-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2018 Accepting new patients

Locations

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1515888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396253290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GUSTAVE L. LEVY PLACE",
            "address_2": "BOX 1070",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E 98TH ST STE 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-241-1101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 E 98th St Ste 4",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296501",
            "country_code": "US",
            "telephone_number": "212-241-1101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19 E 98th St Ste 4",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296501",
            "country_code": "US",
            "telephone_number": "212-241-1101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORREJO",
        "first_name": "XIOMARA",
        "middle_name": "M.",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308282-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.