Active NPI
Connie Pacheco, FNP
- Family Nurse Practitioner
- New York, NY
National Provider Identifier
1538650635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F342499-1
- Practice address
- 425 W 59TH St FL 7
New York, NY 10019 - Phone
- (212) 523-8700
- NPI assigned
- May 23, 2018
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F342499-1 | NY | Primary |
Addresses
Primary practice location
425 W 59TH St FL 7
New York, NY 10019
Mailing address
6314 Wetherole St
Rego Park, NY 11374-2930
Phone (347) 791-4377
Other practice location 1
6314 Wetherole St
Rego Park, NY 11374-2930
Phone (347) 791-4377
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
| License | State | Type | Specialty |
|---|---|---|---|
| F342499-1 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528243200000",
"number": "1538650635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6314 WETHEROLE ST",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742930",
"telephone_number": "347-791-4377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 W 59TH ST FL 7",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10019",
"telephone_number": "212-523-8700"
}
],
"practiceLocations": [
{
"address_1": "6314 Wetherole St",
"address_purpose": "LOCATION",
"city": "Rego Park",
"state": "NY",
"postal_code": "113742930",
"country_code": "US",
"telephone_number": "347-791-4377",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PACHECO",
"first_name": "CONNIE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-23",
"last_updated": "2018-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F342499-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.