Individual provider Active NPI

Maureen Ann Carroll, AGNP-C

  • Adult Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1609455286
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F312055-01 Issued in NY
Practice address
66 Sunset TRL
Bronx, NY 10465-3851
Phone
(646) 784-1529
Fax
(646) 317-1283
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F312055-01 NY Primary

Addresses

Primary practice location

66 Sunset TRL
Bronx, NY 10465-3851

Mailing address

66 Sunset TRL
Bronx, NY 10465-3851

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
I20250114000161 NY Practitioner - Nurse Practitioner 5799213104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

1283 York Ave
New York, NY 10065-5662
Phone (646) 697-0939

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101
  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F312055-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Aug 1, 2025 Accepting new patients
Weill Medical College of Cornell CurrentSince Aug 1, 2025 Accepting new patients
Harmony Medical Services of New York, PLLC CurrentSince Jan 1, 2025 Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

11835 Queens Blvd
Ste 400
Forest Hills, NY 11375
Phone (646) 722-7610

156 William St
Fl 6
New York, NY 10038
Phone (646) 962-2620

Gpo 5907
New York, NY 10087

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

1305 York Ave
Fl 4
New York, NY 10021
Phone (646) 962-4000

170 William St
New York, NY 10038
Phone (212) 238-0100

41 Elizabeth St
New York, NY 10013
Phone (212) 219-0534

1802 Petracca Pl
Ste 103
Whitestone, NY 11357
Phone (646) 722-7610

Networks

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

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1609455286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 SUNSET TRL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104653851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SUNSET TRL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104653851",
            "telephone_number": "646-784-1529",
            "fax_number": "646-317-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MAUREEN",
        "middle_name": "ANN",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F312055-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.