Individual provider Active NPI

Christina Amanda Bridgenauth, NP

  • Family Nurse Practitioner
  • Forest Hills, NY
National Provider Identifier
1447145503
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
356634-01 Issued in NY
Practice address
11241 Queens Blvd Ste Lla
Forest Hills, NY 11375-5564
Phone
(516) 663-6400
NPI assigned
Jun 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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 356634-01 NY Primary

Addresses

Primary practice location

11241 Queens Blvd Ste Lla
Forest Hills, NY 11375-5564

Mailing address

5036 Jericho Tpke Ste 205
Commack, NY 11725-2812
Phone (516) 663-6400

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
I20260408001330 NY Practitioner - Nurse Practitioner 3577038439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
356634-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bethpage Medical, PLLC Past Accepting new patients
Nsuh Plainview Physicians Ufp Corporation PastSince Jan 12, 2026 Accepting new patients

Organizations & group practices 2

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": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1447145503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 JERICHO TPKE STE 205",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252812",
            "telephone_number": "516-663-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11241 QUEENS BLVD STE LLA",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755564",
            "telephone_number": "516-663-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGENAUTH",
        "first_name": "CHRISTINA",
        "middle_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "356634-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.