Individual provider Active NPI

Marie Mondesir, RN

  • Registered Nurse
  • Elmont, NY
National Provider Identifier
1407982986
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
480884 Issued in NY
Practice address
89 Emily Ave
Elmont, NY 11003-4223
Phone
(516) 343-7699
Fax
(516) 352-3977
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 480884 NY Primary

Addresses

Primary practice location

89 Emily Ave
Elmont, NY 11003-4223

Mailing address

89 Emily Ave
Elmont, NY 11003-4223
Phone (516) 343-7699

Other identifiers 1

IdentifierTypeStateIssuer
02374945MedicaidNY

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
480884NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1407982986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 EMILY AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034223",
            "telephone_number": "516-343-7699",
            "fax_number": "845-635-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 EMILY AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034223",
            "telephone_number": "516-343-7699",
            "fax_number": "516-352-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDESIR",
        "first_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "480884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02374945",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.