Active NPI
Nicole Suzanne McCarthy
- Peer Specialist
- Staten Island, NY
National Provider Identifier
1437794997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- CRPA-1880
- Practice address
- 392 Seguine Ave
Staten Island, NY 10309-3906 - Phone
- (718) 226-2622
- NPI assigned
- Nov 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | CRPA-1880 | NY | Primary |
Addresses
Primary practice location
392 Seguine Ave
Staten Island, NY 10309-3906
Mailing address
392 Seguine Ave
Staten Island, NY 10309-3906
Phone (718) 226-2622
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nmccarthy2@northwell.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRPA-1880 | NY | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573171200000",
"number": "1437794997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "392 SEGUINE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103093906",
"telephone_number": "718-226-2622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "392 SEGUINE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103093906",
"telephone_number": "718-226-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCARTHY",
"first_name": "NICOLE",
"middle_name": "SUZANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-08",
"last_updated": "2019-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NY",
"license": "CRPA-1880",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nmccarthy2@northwell.edu",
"affiliation": "N",
"address_1": "392 Seguine Ave",
"city": "Staten Island",
"state": "NY",
"country_code": "US",
"postal_code": "103093906",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.