NPIMap

Organization Active NPI

Vitals Healthcare SVCS

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1467196402
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
VITALS HEALTHCARE SVCS
Practice address
2525 Nostrand Avenue
Apt 2C
Brooklyn, NY 11210-4715
Phone
(917) 907-0797
Fax
(917) 933-4212
NPI assigned
Apr 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Ms. Phedre Phara Paulemon, NPNPI 1376748558
Title
Owner
Phone
(917) 907-0797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2525 Nostrand Avenue
Apt 2C
Brooklyn, NY 11210-4715

Mailing address

2525 Nostrand Avenue Apt 2C
Brooklyn, NY 11210-4715
Phone (917) 907-0797

Other identifiers 1

IdentifierTypeStateIssuer
05401478MedicaidNY

Other names 1

  • VITALS HEALTHCARE SVCs Other name

National Provider Directory

National Provider Directory
Tax ID family
Vitals Healthcare Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1467196402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 NOSTRAND AVENUE APT 2C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112104715",
            "telephone_number": "917-907-0797",
            "fax_number": "917-933-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NOSTRAND AVENUE",
            "address_2": "APT 2C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112104715",
            "telephone_number": "917-907-0797",
            "fax_number": "917-933-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALS HEALTHCARE SVCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "PAULEMON",
        "authorized_official_first_name": "PHEDRE",
        "authorized_official_middle_name": "PHARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-907-0797",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05401478",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VITALS HEALTHCARE SVCs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.