Individual provider Active NPI

Yolima Vergara

  • Gerontology Nurse Practitioner
  • New York, NY
National Provider Identifier
1629522495
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
30307503 Issued in NY
Practice address
423 E 23Rd St
New York, NY 10010-5011
Phone
(212) 686-7500
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 22 500276 NY
Gerontology Nurse Practitioner 363LG0600X 30307503 NY Primary

Addresses

Primary practice location

423 E 23Rd St
New York, NY 10010-5011

Mailing address

134 Roosevelt Ave
Staten Island, NY 10314-4124
Phone (718) 370-2088

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

LicenseStateTypeSpecialty
22 500276NYMDRegistered Nurse
30307503NYMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1629522495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ROOSEVELT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144124",
            "telephone_number": "718-370-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 E 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105011",
            "telephone_number": "212-686-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "YOLIMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22 500276",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "30307503",
            "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 Aug 10, 2016; 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.