NPIMap

Individual provider Active NPI

Heather Fonarev

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1417682782
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310791 Issued in NY
Practice address
160 E 34TH St
New York, NY 10016-4744
Phone
(212) 731-6000
NPI assigned
Jul 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 310791 NY
Acute Care Nurse Practitioner 363LA2100X 310791 NY
Adult Health Nurse Practitioner 363LA2200X 310791 NY Primary

Addresses

Primary practice location

160 E 34TH St
New York, NY 10016-4744

Mailing address

20 Randolph PL
West Orange, NJ 07052-4808
Phone (978) 793-3782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240810000372 NY Practitioner - Nurse Practitioner 1355716903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

160 E 34TH St
New York, NY 10016-4744
Phone (212) 263-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
310791NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 1, 2024 Accepting new patients
New York University CurrentSince Jul 1, 2024 Accepting new patients

Locations

160 E 34th St
New York, NY 10016
Phone (212) 731-5180

1 Park Ave
Fl 10
New York, NY 10016
Phone (212) 404-3715

Networks

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

Interoperability endpoints

  • Direct secure messaging: hfonarev140633@nyumc.direct-ci.com

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1417682782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RANDOLPH PL",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524808",
            "telephone_number": "978-793-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164744",
            "telephone_number": "212-731-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONAREV",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NY",
            "license": "310791",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "310791",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.