Individual provider Active NPI

Lucy Wagner

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1508660515
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F433009 Issued in NY
Practice address
100 E 74TH St
New York, NY 10021-3544
Phone
(212) 434-4000
NPI assigned
Apr 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F433009 NY Primary

Addresses

Primary practice location

100 E 74TH St
New York, NY 10021-3544

Mailing address

232 E 74TH St Apt 2C
New York, NY 10021-3632
Phone (908) 963-9549

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
I20260112002517 NY Practitioner - Nurse Practitioner 2668958497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

400 Kelby St
FL 9
Fort Lee, NJ 07024-2939

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F433009NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 6, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Dec 6, 2025 Accepting new patients

Locations

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1508660515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 E 74TH ST APT 2C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213632",
            "telephone_number": "908-963-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 74TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213544",
            "telephone_number": "212-434-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LUCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F433009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.