Individual provider Active NPI

Martine Bouzi, PNP

  • Critical Care Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1548367188
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
381562 Issued in NY
Practice address
530 1St Ave
New York, NY 10016-6402
Phone
(212) 263-5989
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 381562 NY Primary

Addresses

Primary practice location

530 1St Ave
New York, NY 10016-6402

Mailing address

81 Lincoln PL
Freeport, NY 11520-2130
Phone (516) 771-6886

Other practice location 1

3415 Bainbridge Ave
Bronx, NY 10467-2403
Phone (718) 920-7745

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbouzi80447@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071120000546 NY Practitioner - Nurse Practitioner 0244328524 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 21, 2018 Accepting new patients
New York University CurrentSince Aug 21, 2018 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jan 6, 2018 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

26901 76th Ave
Ste 365
New Hyde Park, NY 11040
Phone (718) 470-3480

1111 Marcus Ave
Ste M15
New Hyde Park, NY 11042
Phone (516) 601-7200

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: martinebouzi@nslijmedgr.allscriptsdirect.net

Organizations & group practices 3

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1548367188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 LINCOLN PL",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202130",
            "telephone_number": "516-771-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3415 Bainbridge Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672403",
            "country_code": "US",
            "telephone_number": "718-920-7745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUZI",
        "first_name": "MARTINE",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "NY",
            "license": "381562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbouzi80447@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "530 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.