Active NPI
Nancy Ann Enterlin, NP
- Nurse Practitioner
- Stony Brook, NY
National Provider Identifier
1447567532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- F350316
- Practice address
- 100 Nicolls Rd
Stony Brook University Medical Center, L11 N
Stony Brook, NY 11790-3407 - Phone
- (631) 444-2730
- NPI assigned
- Sep 10, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F350316 | NY | Primary |
Addresses
Primary practice location
100 Nicolls Rd
Stony Brook University Medical Center, L11 N
Stony Brook, NY 11790-3407
Mailing address
PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-0650
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F350316 | NY | MD | Nurse Practitioner |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- nancy.enterlin@direct.stonybrookmedicine.edu
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.
-
- Pediatrics Physician
- Stony Brook, NY
- NPI 1083660575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431129600000",
"number": "1447567532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1559",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117900989",
"telephone_number": "631-444-0650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 NICOLLS RD",
"address_2": "STONY BROOK UNIVERSITY MEDICAL CENTER, L11 N",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117903407",
"telephone_number": "631-444-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENTERLIN",
"first_name": "NANCY",
"middle_name": "ANN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-10",
"last_updated": "2015-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "F350316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.