Individual provider Active NPI

Princymol Nicemon Joseph

  • Adult Health Nurse Practitioner
  • Manhasset, NY
National Provider Identifier
1497219364
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308905 Issued in NY
Practice address
Northshore University Hospital, Department of Neurosur
300 Community Drive
Manhasset, NY 11030
Phone
(516) 562-4300
NPI assigned
Jan 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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 308905 NY Primary

Addresses

Primary practice location

Northshore University Hospital, Department of Neurosur
300 Community Drive
Manhasset, NY 11030

Mailing address

Northshore University Hospital, Neurosurgery, 9 Tower
300 Community Drive
Manhasset, NY 11030-1636
Phone (516) 562-4300

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
I20200213000643 NY Practitioner - Nurse Practitioner 4880020775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3058

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308905NYMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 16, 2019 Accepting new patients

Locations

450 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 321-3000

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: pjoseph319684@northwell.direct-ci.com

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.

Hospital & facility affiliations 3

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": "1548374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1497219364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTHSHORE UNIVERSITY HOSPITAL, NEUROSURGERY, 9 TOWER",
            "address_2": "300 COMMUNITY DRIVE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110301636",
            "telephone_number": "516-562-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHSHORE UNIVERSITY HOSPITAL, DEPARTMENT OF NEUROSUR",
            "address_2": "300 COMMUNITY DRIVE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-562-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "PRINCYMOL",
        "middle_name": "NICEMON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-25",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.