Individual provider Active NPI

Tabitha Joy Locklear-Valerio, FNP-BC

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1619414802
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F34225701 Issued in NY
Practice address
202 Foster Ave Ste a
Brooklyn, NY 11230-2130
Phone
(347) 295-1525
Fax
(212) 658-9759
NPI assigned
Jan 25, 2017
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F34225701 NY Primary
Family Nurse Practitioner 363LF0000X 342257 NY

Addresses

Primary practice location

202 Foster Ave Ste a
Brooklyn, NY 11230-2130

Mailing address

202 Foster Ave Ste a
Brooklyn, NY 11230-2130
Phone (347) 295-1525

Other identifiers 1

IdentifierTypeStateIssuer
05219118MedicaidNY

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
I20180711000701 NY Practitioner - Nurse Practitioner 2769738442 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F34225701NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MBD Care LLC PastSince Apr 10, 2019 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1619414802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 FOSTER AVE STE A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302130",
            "telephone_number": "347-295-1525",
            "fax_number": "212-658-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 FOSTER AVE STE A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302130",
            "telephone_number": "347-295-1525",
            "fax_number": "212-658-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKLEAR-VALERIO",
        "first_name": "TABITHA",
        "middle_name": "JOY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F34225701",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05219118",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.