Individual provider Active NPI

Mary Frances Bernadette McGibbon, DNP FNP

  • Family Nurse Practitioner
  • Huntington Station, NY
National Provider Identifier
1447432497
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F-331103-1 Issued in NY
Practice address
180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone
(631) 425-2140
Fax
(631) 425-2167
NPI assigned
Dec 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 F-331103-1 NY Primary

Addresses

Primary practice location

180 E Pulaski Rd
Huntington Station, NY 11746-1915

Mailing address

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (631) 425-2140

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmcgibbon152847@nyumc.direct-ci.com

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
I20170130002310 NY Practitioner - Nurse Practitioner 3678855574 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F-331103-1NYMDFamily Nurse Practitioner
331103NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 1, 2017 Accepting new patients
New York University CurrentSince Jan 1, 2017 Accepting new patients

Locations

180 Pulaski Rd
Huntington Station, NY 11746
Phone (631) 425-2121

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

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": "1196467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1447432497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2140",
            "fax_number": "631-425-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2140",
            "fax_number": "631-425-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGIBBON",
        "first_name": "MARY FRANCES",
        "middle_name": "BERNADETTE",
        "name_prefix": "Dr.",
        "credential": "DNP FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-01",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F-331103-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcgibbon152847@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "180 E Pulaski Rd",
            "city": "Huntington Station",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117461915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Station, NY

Sources for this page

Verify at the official NPI Registry.