Individual provider Active NPI

Patricia Angela Nelson

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1497419246
Registry record updated Oct 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F348406-01 Issued in NY
Practice address
374 Stockholm St
Brooklyn, NY 11237-4006
Phone
(718) 963-7272
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F348406-01 NY
Family Nurse Practitioner 363LF0000X F348406-01 NY Primary

Addresses

Primary practice location

374 Stockholm St
Brooklyn, NY 11237-4006

Mailing address

82 Lucille St
Hempstead, NY 11550-5843

Other practice location 1

1610 Dekalb Ave
Brooklyn, NY 11237-4190
Phone (718) 302-8481

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
I20211209000620 NY Practitioner - Nurse Practitioner 3072903988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyckoff Professional Medical Services PCGroup PAC ID 6406748607, 154 clinicians

Practice addresses (Care Compare)

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7266

Hospital & facility affiliations

  • Wyckoff Heights Medical Center Hospital, Brooklyn, NY, CCN 330221

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F348406-01NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC CurrentSince Nov 1, 2021 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

Networks

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

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 1

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": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635552000000",
    "number": "1497419246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 LUCILLE ST",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115505843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 Dekalb Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112374190",
            "country_code": "US",
            "telephone_number": "718-302-8481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PATRICIA",
        "middle_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-30",
        "certification_date": "2021-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F348406-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F348406-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.