Individual provider Active NPI

Ebony Baker

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1417831967
Registry record updated Nov 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
357951 Issued in NY
Practice address
220 E 42ND St FL 7
New York, NY 10017-5835
Phone
(917) 608-0712
NPI assigned
Aug 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 357951 NY Primary
Registered Nurse 163W00000X 765143 NY

Addresses

Primary practice location

220 E 42ND St FL 7
New York, NY 10017-5835

Mailing address

36 Hilton Ave Apt 306
Hempstead, NY 11550-2116
Phone (347) 593-0851

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
I20260610001867 NY Practitioner - Nurse Practitioner 9436630894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2050 Lakeville Rd
2 Ecm 2ND Floor
New Hyde Park, NY 11040-1639

22414 Merrick Blvd
Suite B2ND
Laurelton, NY 11413-2023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
765143NYMDRegistered Nurse
357951NYMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1754352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1417831967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HILTON AVE APT 306",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115502116",
            "telephone_number": "347-593-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E 42ND ST FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175835",
            "telephone_number": "917-608-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "EBONY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357951",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "765143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.