Individual provider Active NPI

Judith Severin Avin, NURSE PRACTITIONER

  • Critical Care Neonatal Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1407505480
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
F350463-01 Issued in NY
Practice address
8268 164TH St Ste P113
Jamaica, NY 11432-1104
Phone
(718) 883-4500
Fax
(718) 883-6106
NPI assigned
Mar 18, 2022
Last updated
Mar 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X F350463-01 NY Primary

Addresses

Primary practice location

8268 164TH St Ste P113
Jamaica, NY 11432-1104

Mailing address

8268 164TH St Ste P113
Jamaica, NY 11432-1104
Phone (718) 883-4500

Other names 1

  • Judith Severin Former name

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

LicenseStateTypeSpecialty
F350463-01NYMDCritical Care Neonatal Nurse Practitioner

Networks

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

Interoperability endpoints

  • Direct secure messaging: javin2132650@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1407505480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8268 164TH ST STE P113",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321104",
            "telephone_number": "718-883-4500",
            "fax_number": "718-883-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8268 164TH ST STE P113",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321104",
            "telephone_number": "718-883-4500",
            "fax_number": "718-883-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERIN AVIN",
        "first_name": "JUDITH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "NY",
            "license": "F350463-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "SEVERIN",
            "credential": "REGISTERED NURSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.