Individual provider Active NPI

Noelle Denome, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Valhalla, NY
National Provider Identifier
1407628217
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311239 Issued in NY
Practice address
15 Dana Rd
Valhalla, NY 10595-1554
Phone
(914) 594-4234
NPI assigned
Oct 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

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 311239 NY Primary

Addresses

Primary practice location

15 Dana Rd
Valhalla, NY 10595-1554

Mailing address

2660 Loretta St
Yorktown Heights, NY 10598-2926
Phone (845) 558-8168

Other practice location 1

15 Dana Rd
Valhalla, NY 10595-1554
Phone (914) 594-4234

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
I20250909004625 NY Order and Referring Only - Nurse Practitioner 1153824909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
311239NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1407628217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 LORETTA ST",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105982926",
            "telephone_number": "845-558-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DANA RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951554",
            "telephone_number": "914-594-4234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Dana Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951554",
            "country_code": "US",
            "telephone_number": "914-594-4234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENOME",
        "first_name": "NOELLE",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.