Individual provider Active NPI

Johanne Maurisset

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1427570530
Registry record updated Jul 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341396-1 Issued in NY
Practice address
160 Water St
New York, NY 10038-4922
Phone
(917) 669-1707
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2017

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 F341396-1 NY Primary

Addresses

Primary practice location

160 Water St
New York, NY 10038-4922

Mailing address

35 Pewter LN
Hicksville, NY 11801-6213
Phone (516) 860-2717

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
I20200526001620 NY Practitioner - Nurse Practitioner 1951722164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Care at Home PCGroup PAC ID 1557403235, 7 clinicians

Practice addresses (Care Compare)

220 E 42ND St
FL 6
New York, NY 10017-5831
Phone (646) 453-6900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F341396-1NYMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ms_jmauriss@landmarkhealth-direct.org
  • Direct secure messaging: johanne.maurisset.1@30409.direct.athenahealth.com

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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1427570530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PEWTER LN",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016213",
            "telephone_number": "516-860-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WATER ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384922",
            "telephone_number": "917-669-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURISSET",
        "first_name": "JOHANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341396-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.