Individual provider Active NPI

Phoebe Krisell Coronel Arceo

  • Gerontology Registered Nurse
  • Staten Island, NY
National Provider Identifier
1457182248
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
828360-01 Issued in NY
Practice address
18 Carnegie Ave FL 1
Staten Island, NY 10314-3820
Phone
(929) 215-5513
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 828360-01 NY
Home Health Registered Nurse 163WH0200X 828360-01 NY
Gerontology Registered Nurse 163WG0600X 828360-01 NY Primary

Addresses

Primary practice location

18 Carnegie Ave FL 1
Staten Island, NY 10314-3820

Mailing address

18 Carnegie Ave FL 1
Staten Island, NY 10314-3820
Phone (929) 215-5513

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
828360-01NYMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1457182248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CARNEGIE AVE FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143820",
            "telephone_number": "929-215-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CARNEGIE AVE FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143820",
            "telephone_number": "929-215-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCEO",
        "first_name": "PHOEBE KRISELL",
        "middle_name": "CORONEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NY",
            "license": "828360-01",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "828360-01",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NY",
            "license": "828360-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.