Individual provider Active NPI

Vanessa Elliott

  • Family Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1477158665
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345999-01 Issued in NY
Practice address
3003 New Hyde Park Rd Ste 407
New Hyde Park, NY 11042-1214
Phone
(516) 488-8145
NPI assigned
Dec 3, 2020
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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 F345999-01 NY Primary

Addresses

Primary practice location

3003 New Hyde Park Rd Ste 407
New Hyde Park, NY 11042-1214

Mailing address

9707 Plattwood Ave
Ozone Park, NY 11417-2127
Phone (347) 744-0641

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
I20240730000704 NY Practitioner - Nurse Practitioner 9739626565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Internal Medicine at New Hyde Park PCGroup PAC ID 0648493908, 8 clinicians

Practice addresses (Care Compare)

3003 New Hyde Park Rd
Suite 303
New Hyde Park, NY 11042-1214
Phone 5163260707516326

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F345999-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Lij Internal Medicine at New Hyde Park PC CurrentSince May 17, 2024 Accepting new patients
North Shore -Lij OB-GYN at New Hyde Park, P.C. CurrentSince Dec 6, 2020 Accepting new patients
CHS Physician Partners, P.C Past Accepting new patients
Long Island Women's Obstetrics and Gynecology PLLC PastSince Dec 6, 2020 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

3003 New Hyde Park Rd
Ste 303
New Hyde Park, NY 11042
Phone (516) 326-0707

3003 New Hyde Park Rd
Ste 407
New Hyde Park, NY 11042
Phone (516) 488-8145

27005 76th Ave
North New Hyde Pk, NY 11040

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1477158665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9707 PLATTWOOD AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114172127",
            "telephone_number": "347-744-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK RD STE 407",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421214",
            "telephone_number": "516-488-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345999-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.