Active NPI
Liselle Loyola, FNP-BC
- Family Nurse Practitioner
- Brooklyn, NY
National Provider Identifier
1629843149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F352080-01
- Practice address
- 535 Clinton Ave
Brooklyn, NY 11238-6589 - Phone
- (917) 410-6905
- NPI assigned
- Nov 15, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F352080-01 | NY | Primary |
Addresses
Primary practice location
535 Clinton Ave
Brooklyn, NY 11238-6589
Mailing address
535 Clinton Ave
Brooklyn, NY 11238-6589
Phone (917) 410-6905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250506002266 | NY | Order and Referring Only - Nurse Practitioner | 1254858921 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F352080-01 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741824000000",
"number": "1629843149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 CLINTON AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112386589",
"telephone_number": "917-410-6905",
"fax_number": "646-878-6095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 CLINTON AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112386589",
"telephone_number": "917-410-6905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOYOLA",
"first_name": "LISELLE",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-15",
"last_updated": "2025-03-13",
"certification_date": "2025-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F352080-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.