Active NPI
Chelise Mae Deoliveira, PNP
- Pediatric Nurse Practitioner
- Mineola, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- F382331-1
- Practice address
- 259 1St St
Mineola, NY 11501-3957 - Phone
- (516) 663-2288
- NPI assigned
- Dec 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | F382331-1 | NY | Primary |
Addresses
Primary practice location
259 1St St
Mineola, NY 11501-3957
Mailing address
259 1St St
Mineola, NY 11501-3957
Other practice location 1
475 Seaview Ave
Staten Island, NY 10305-3436
Phone (516) 313-7323
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ccameron288213@nyumc.direct-ci.com |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F382331-1 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Physicians of University Hospital, PC | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Physicians of University Hospital, PC | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064
259 1st St
Mineola, NY 11501
Phone (516) 576-1820
300 Community Dr
Plandome, NY 11030
1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047
242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458
475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855
401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Interoperability endpoints
- ccameron288213@nyumc.direct-ci.com
Organizations & group practices 5
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.
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Geriatric Medicine (Internal Medicine) Physician
- Staten Island, NY
- NPI 1417901323
-
- Anesthesiology Physician
- Bay Shore, NY
- NPI 1023513116
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1508101528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 1ST ST",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115013957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 1ST ST",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115013957",
"telephone_number": "516-663-2288"
}
],
"practiceLocations": [
{
"address_1": "475 Seaview Ave",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103053436",
"country_code": "US",
"telephone_number": "516-313-7323",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEOLIVEIRA",
"first_name": "CHELISE",
"middle_name": "MAE",
"name_prefix": "Mrs.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-03",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "F382331-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ccameron288213@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "259 1st St",
"city": "Mineola",
"state": "NY",
"country_code": "US",
"postal_code": "115013957",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mineola, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.