Vedalie Souvenance, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F311426-01 Issued in NY

Practice address

21229 Hillside Ave Apt 3Je
Queens Village, NY 11427-1851

Phone

(917) 825-0930

NPI assigned

Oct 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Vedalie Souvenance Other name

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ilm Medical Care PLLCGroup PAC ID 2769610989, 37 clinicians

Bronx Medical Practice PCGroup PAC ID 9739496100, 136 clinicians

Py Medical Services of Ny PLLCGroup PAC ID 8921476391, 16 clinicians

Silver Star Medical Association of NJ PCGroup PAC ID 9234597402, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ilm Medical Care PLLC

  • Specialist
  • Brooklyn, NY
  • NPI 1023442035
  Medicare reassignment Care Compare group NPD
• Py Medical Services of Ny PLLC

  • Internal Medicine Physician
  • Fowler, OH
  • NPI 1760199988

  NY

  Medicare reassignment Care Compare group NPD
• Silver Star Medical Association of NJ PC

  • Internal Medicine Physician
  • Upper Saddle River, NJ
  • NPI 1710677091

  NY

  Medicare reassignment Care Compare group NPD
• Bronx Medical Practice P.C.

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1356726087
  Medicare reassignment Care Compare group
• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  NY

  Medicare reassignment NPD
• Essen Medical Associates, PC

  • Legal Medicine
  • Bronx, NY
  • NPI 1366418709
  Medicare reassignment
• House Call Medical Services of New York, PLLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1851345946
  Medicare reassignment
• Peyman Younesi MD PLLC

  • Internal Medicine Physician
  • Fresh Meadows, NY
  • NPI 1891053328
  NPD (past)

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1407455884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 DEKOVEN ST",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703402",
            "telephone_number": "917-825-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21229 HILLSIDE AVE APT 3JE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271851",
            "telephone_number": "917-825-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUVENANCE",
        "first_name": "VEDALIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-18",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311426-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "784731-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "F311426-01",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F311426-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VEDALIE",
            "last_name": "SOUVENANCE",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Yeghia Sounboolian, MD,MS
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• Leighton Spence
• Arlene Robin Spiegelman, CCC/SLP
• Spring RX Inc
• Springfield Pharmacy Inc

• Adult Health Nurse Practitioner in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.