Individual provider Active NPI

Anne-Edith Thelusca, A-GNP-C

  • Gerontology Nurse Practitioner
  • Syosset, NY
National Provider Identifier
1437863719
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
311159 Issued in NY
Practice address
99 Lafayette Dr Ste 201
Syosset, NY 11791-3933
Phone
(516) 734-7000
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 311159 NY Primary

Addresses

Primary practice location

99 Lafayette Dr Ste 201
Syosset, NY 11791-3933

Mailing address

99 Lafayette Dr Ste 201
Syosset, NY 11791-3933
Phone (516) 734-7000

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
I20260326001455 NY Practitioner - Nurse Practitioner 8224513486 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
Nyc-Metro Physician Services PCGroup PAC ID 3375807571, 3 clinicians

Practice addresses (Care Compare)

27111 76TH Ave
New Hyde Park, NY 11040-1436
Phone (718) 289-2606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1437863719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 LAFAYETTE DR STE 201",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913933",
            "telephone_number": "516-734-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 LAFAYETTE DR STE 201",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913933",
            "telephone_number": "516-734-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELUSCA",
        "first_name": "ANNE-EDITH",
        "credential": "A-GNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "311159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.