Individual provider Active NPI

Lajuan Bethune Booker, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1437522307
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339938 Issued in NY
Practice address
3215 Fulton St
Brooklyn, NY 11208-1907
Phone
(833) 244-7111
NPI assigned
Nov 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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 339938 NY
Family Nurse Practitioner 363LF0000X F339938 NY Primary

Addresses

Primary practice location

3215 Fulton St
Brooklyn, NY 11208-1907

Mailing address

24 Knights Cir
Newburgh, NY 12550-2422
Phone (917) 273-7686

Other practice location 1

147 Lake St
Newburgh, NY 12550-5263
Phone (845) 563-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339938NYMDFamily Nurse Practitioner
F339938NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Jan 1, 2023 Accepting new patients
Nyc Medical Doctor P.C. CurrentSince Apr 13, 2019 Accepting new patients
Health Shared Physicians, PLLC CurrentSince Apr 3, 2020 Accepting new patients

Locations

699 Stanley Ave
Brooklyn, NY 11207
Phone (347) 689-8880

979 Fulton St
Brooklyn, NY 11238
Phone (718) 857-1200

76 Belmont Ave
Brooklyn, NY 11212
Phone (347) 754-6012

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Organizations & group practices 3

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": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1437522307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 KNIGHTS CIR",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502422",
            "telephone_number": "917-273-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112081907",
            "telephone_number": "833-244-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Lake St",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125505263",
            "country_code": "US",
            "telephone_number": "845-563-8000",
            "fax_number": "845-534-2940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETHUNE BOOKER",
        "first_name": "LAJUAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-02",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339938",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.