Individual provider Active NPI

Elena Margaret Heck

  • Family Nurse Practitioner
  • Selden, NY
National Provider Identifier
1477909588
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F350659-01 Issued in NY
Practice address
21 Deville Dr
Selden, NY 11784-1003
Phone
(631) 644-4342
NPI assigned
May 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 607053 NY
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X F350659-01 NY Primary

Addresses

Primary practice location

21 Deville Dr
Selden, NY 11784-1003

Mailing address

21 Deville Dr
Selden, NY 11784-1003
Phone (631) 644-4342

Other names 1

  • Elena Margaret Kenski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
607053NYMDMedical-Surgical Registered Nurse
F350659-01NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1477909588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DEVILLE DR",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117841003",
            "telephone_number": "631-644-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DEVILLE DR",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117841003",
            "telephone_number": "631-644-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECK",
        "first_name": "ELENA",
        "middle_name": "MARGARET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "607053",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F350659-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "KENSKI",
            "middle_name": "MARGARET",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Selden, NY

Sources for this page

Verify at the official NPI Registry.