Individual provider Active NPI

Dawn Pamela Minuto, LPN

  • Licensed Practical Nurse
  • Deer Park, NY
National Provider Identifier
1447442686
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2222771 Issued in NY
Practice address
49 Summerfield CT
Deer Park, NY 11729
Phone
(631) 242-9657
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2222771 NY Primary

Addresses

Primary practice location

49 Summerfield CT
Deer Park, NY 11729

Mailing address

49 Summerfield CT
Deer Park, NY 11729
Phone (631) 242-9657

Other identifiers 1

IdentifierTypeStateIssuer
02165222MedicaidNY

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

LicenseStateTypeSpecialty
2222771NYMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1447442686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 SUMMERFIELD CT",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "11729",
            "telephone_number": "631-242-9657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 SUMMERFIELD CT",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "11729",
            "telephone_number": "631-242-9657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINUTO",
        "first_name": "DAWN",
        "middle_name": "PAMELA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2222771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02165222",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.