Individual provider Active NPI

Peter Nicholas Quintanilla, RN

  • Medical-Surgical Registered Nurse
  • Staten Island, NY
National Provider Identifier
1598919854
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
598582 Issued in NY
Practice address
86 Lexington Ave
Staten Island, NY 10302-2023
Phone
(718) 510-4064
NPI assigned
Nov 12, 2008
Last updated
Nov 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 598582 NY Primary

Addresses

Primary practice location

86 Lexington Ave
Staten Island, NY 10302-2023

Mailing address

86 Lexington Ave
Staten Island, NY 10302-2023
Phone (718) 510-4064

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
598582NYMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1598919854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 LEXINGTON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022023",
            "telephone_number": "718-510-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 LEXINGTON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022023",
            "telephone_number": "718-510-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANILLA",
        "first_name": "PETER",
        "middle_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-12",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "598582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.