Organization Active NPI

Nicole M O'Brien Nurse Practitioner in Family Health PLLC

  • Nurse Practitioner
  • Halfmoon, NY
National Provider Identifier
1497591523
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
NICOLE M O'BRIEN NURSE PRACTITIONER IN FAMILY HEALTH PLLC
Practice address
1520 Route 9
Halfmoon, NY 12065-5669
Phone
(518) 371-7723
Fax
(518) 482-2110
NPI assigned
Jul 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Nicole M O'Brien, FNP-BC, DCNPNPI 1699325654
Title
FNP-BC, DCNP/Owner
Phone
(518) 588-4222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

1520 Route 9
Halfmoon, NY 12065-5669

Mailing address

1520 Route 9
Halfmoon, NY 12065-5669
Phone (518) 371-7723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240802002771 NY Part B Supplier - Clinic/Group Practice 1153868567 Receives reassigned benefits from 2 practitioners
Practice locations: Halfmoon, NY

National Provider Directory

National Provider Directory

Locations

1520 Route 9
Ste 1
Halfmoon, NY 12065

1520 Route 9
Halfmoon, NY 12065
Phone (518) 371-7723

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1497591523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 ROUTE 9",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120655669",
            "telephone_number": "518-371-7723",
            "fax_number": "518-482-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 ROUTE 9",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120655669",
            "telephone_number": "518-371-7723",
            "fax_number": "518-482-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE M O'BRIEN NURSE PRACTITIONER IN FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FNP-BC, DCNP/OWNER",
        "authorized_official_telephone_number": "518-588-4222",
        "authorized_official_credential": "FNP-BC, DCNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halfmoon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.