Individual provider Active NPI

Cassandra Markham

  • Family Nurse Practitioner
  • East Meadow, NY
National Provider Identifier
1417659228
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F350899-01 Issued in NY
Practice address
50 Dorothy Dr
East Meadow, NY 11554-1118
Phone
(516) 870-2065
NPI assigned
Mar 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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 F350899-01 NY Primary

Addresses

Primary practice location

50 Dorothy Dr
East Meadow, NY 11554-1118

Mailing address

50 Dorothy Dr
East Meadow, NY 11554-1118
Phone (516) 870-2065

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
I20240430004324 NY Practitioner - Nurse Practitioner 7618317165 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F350899-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Services of Kips Bay PC CurrentSince Mar 13, 2024 Accepting new patients
Medical Services of Kips Bay PC CurrentSince Mar 13, 2024 Accepting new patients

Locations

825 Northern Blvd
Ste 201
Great Neck, NY 11021
Phone (516) 396-7846

170 Great Neck Rd
Great Neck, NY 11021
Phone (516) 487-4464

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1417659228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 DOROTHY DR",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541118",
            "telephone_number": "516-870-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 DOROTHY DR",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541118",
            "telephone_number": "516-870-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKHAM",
        "first_name": "CASSANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F350899-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.