Individual provider Active NPI

Viola Chaka

  • Primary Care Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1497568869
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
353611 Issued in NY
Practice address
176 Elvin St
Staten Island, NY 10314-5302
Phone
(718) 869-6485
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 353611 NY Primary

Addresses

Primary practice location

176 Elvin St
Staten Island, NY 10314-5302

Mailing address

176 Elvin St
Staten Island, NY 10314-5302
Phone (718) 869-6485

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

State licenses

LicenseStateTypeSpecialty
353611NYMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1497568869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 ELVIN ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145302",
            "telephone_number": "718-869-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 ELVIN ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145302",
            "telephone_number": "718-869-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKA",
        "first_name": "VIOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "353611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.