Active NPI
Theresa Mary Renart
- Adult Health Nurse Practitioner
- Bayside Hills, NY
National Provider Identifier
1396456083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F311100-01
- Practice address
- 4830 Bell Blvd
Bayside Hills, NY 11364-1236 - Phone
- (347) 403-0337
- Fax
- (718) 423-1969
- NPI assigned
- Dec 13, 2022
- Last updated
- Dec 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F311100-01 | NY | Primary |
Addresses
Primary practice location
4830 Bell Blvd
Bayside Hills, NY 11364-1236
Mailing address
4830 Bell Blvd
Bayside Hills, NY 11364-1236
Phone (347) 403-0337
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | theresa.renart@elderservehealth.org | Health Information Exchange (HIE) | |
| CONNECT URL | theresa.renart@elderservehealth.org | Other | |
| Other URL | theresa.renart@elderservehealth.org | Health Information Exchange (HIE) | |
| Direct Messaging Address | theresa.renart@elderservehealth.org | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F311100-01 | NY | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1396456083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4830 BELL BLVD",
"city": "BAYSIDE HILLS",
"state": "NY",
"postal_code": "113641236",
"telephone_number": "347-403-0337",
"fax_number": "718-423-1969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4830 BELL BLVD",
"city": "BAYSIDE HILLS",
"state": "NY",
"postal_code": "113641236",
"telephone_number": "347-403-0337",
"fax_number": "718-423-1969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENART",
"first_name": "THERESA",
"middle_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-13",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F311100-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "theresa.renart@elderservehealth.org",
"affiliation": "N",
"endpointDescription": "secure website",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "theresa.renart@elderservehealth.org",
"address_1": "4830 Bell Blvd",
"city": "Bayside Hills",
"state": "NY",
"country_code": "US",
"postal_code": "113641236",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "theresa.renart@elderservehealth.org",
"affiliation": "N",
"endpointDescription": "secure website",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "theresa.renart@elderservehealth.org",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "theresa.renart@elderservehealth.org",
"address_1": "4830 Bell Blvd",
"city": "Bayside Hills",
"state": "NY",
"country_code": "US",
"postal_code": "113641236",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "theresa.renart@elderservehealth.org",
"affiliation": "N",
"endpointDescription": "secure website",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "theresa.renart@elderservehealth.org",
"address_1": "4830 Bell Blvd",
"city": "Bayside Hills",
"state": "NY",
"country_code": "US",
"postal_code": "113641236",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "theresa.renart@elderservehealth.org",
"affiliation": "N",
"endpointDescription": "secure website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "theresa.renart@elderservehealth.org",
"address_1": "4830 Bell Blvd",
"city": "Bayside Hills",
"state": "NY",
"country_code": "US",
"postal_code": "113641236",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bayside Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.