Individual provider Active NPI

Candace Nicoleau, NP

  • Adult Health Nurse Practitioner
  • East Meadow, NY
National Provider Identifier
1487206991
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309270 Issued in NY
Practice address
2570 Hempstead Tpke Unit 2
East Meadow, NY 11554-2146
Phone
(516) 548-0600
Fax
(516) 548-0605
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309270 NY Primary

Addresses

Primary practice location

2570 Hempstead Tpke Unit 2
East Meadow, NY 11554-2146

Mailing address

2570 Hempstead Tpke Unit 2
East Meadow, NY 11554-2146
Phone (516) 548-0600

Other practice location 1

9204 Springfield Blvd
Queens Village, NY 11428-1857
Phone (718) 465-3040 ext. 121

Other practice location 2

20507 Hillside Ave Ste 10
Hollis, NY 11423-2220
Phone (718) 464-5780 ext. 121

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309270NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Be Totally Well LLC Adult Health CurrentSince Jun 18, 2023 Accepting new patients
Queens Village Primary Medical Care, PLLC Past Accepting new patients

Locations

2570 Hempstead Tpke
Unit 2
East Meadow, NY 11554
Phone (516) 548-0600

9204 Springfield Blvd
Queens Vlg, NY 11428
Phone (718) 464-5780

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1487206991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 HEMPSTEAD TPKE UNIT 2",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542146",
            "telephone_number": "516-548-0600",
            "fax_number": "844-689-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 HEMPSTEAD TPKE UNIT 2",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542146",
            "telephone_number": "516-548-0600",
            "fax_number": "516-548-0605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9204 Springfield Blvd",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114281857",
            "country_code": "US",
            "telephone_number": "718-465-3040 x121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20507 Hillside Ave Ste 10",
            "address_purpose": "LOCATION",
            "city": "Hollis",
            "state": "NY",
            "postal_code": "114232220",
            "country_code": "US",
            "telephone_number": "718-464-5780 x121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLEAU",
        "first_name": "CANDACE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.