Individual provider Active NPI

Vicenta Pichon, RN

  • Home Health Registered Nurse
  • Port Jefferson Station, NY
National Provider Identifier
1487520862
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
847083 Issued in NY
Practice address
40 Shenandoah Blvd
Port Jefferson Station, NY 11776-2041
Phone
(631) 882-5508
NPI assigned
Oct 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WH0200X 847083 NY Primary

Addresses

Primary practice location

40 Shenandoah Blvd
Port Jefferson Station, NY 11776-2041

Mailing address

40 Shenandoah Blvd
Port Jefferson Station, NY 11776-2041
Phone (631) 882-5508

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
847083NYMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1487520862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SHENANDOAH BLVD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762041",
            "telephone_number": "631-882-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SHENANDOAH BLVD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762041",
            "telephone_number": "631-882-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICHON",
        "first_name": "VICENTA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "847083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.