Individual provider Active NPI

Amanda Luong, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1487904389
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
340759 Issued in NY
Practice address
601 W 113TH St Apt 1a
New York, NY 10025-9701
Phone
(212) 326-5705
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2269786 MA
Family Nurse Practitioner 363LF0000X 340759 NY Primary

Addresses

Primary practice location

601 W 113TH St Apt 1a
New York, NY 10025-9701

Mailing address

601 W 113TH St Apt 1a
New York, NY 10025-9701
Phone (212) 326-5705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220426003219 FL Order and Referring Only - Nurse Practitioner 0941448864

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
340759NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida State University Past Accepting new patients

Organizations & group practices 1

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": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1487904389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 113TH ST APT 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100259701",
            "telephone_number": "212-326-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 113TH ST APT 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100259701",
            "telephone_number": "212-326-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "AMANDA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2269786",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.