Individual provider Active NPI

Michelle Giannattasio, NP-C

  • Family Nurse Practitioner
  • Great Neck, NY
National Provider Identifier
1417472440
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341892-1 Issued in NY
Practice address
865 Northern Blvd Ste 101
Great Neck, NY 11021-5310
Phone
(516) 622-5070
NPI assigned
Aug 10, 2017
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F341892-1 NY Primary

Addresses

Primary practice location

865 Northern Blvd Ste 101
Great Neck, NY 11021-5310

Mailing address

236 Willow St
Massapequa Park, NY 11762-1752
Phone (516) 384-3585

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
I20180402000620 NY Practitioner - Nurse Practitioner 7012279011 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F341892-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
North Shore Long Island Jewish Health Care Inc PastSince Apr 6, 2025 Accepting new patients

Locations

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

300 Community Dr
Manhasset, NY 11030

300 Old Country Rd
Ste 101
Mineola, NY 11501
Phone (516) 400-2988

Networks

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

Interoperability endpoints

  • Direct secure messaging: michellegiannattasio@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1417472440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 WILLOW ST",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117621752",
            "telephone_number": "516-384-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 NORTHERN BLVD STE 101",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215310",
            "telephone_number": "516-622-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANNATTASIO",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341892-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.