Individual provider Active NPI

Sara Pearson, FNP

  • Family Medicine Physician
  • Ronkonkoma, NY
National Provider Identifier
1629884077
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F353498-01 Issued in NY
Practice address
501 Hawkins Ave
Ronkonkoma, NY 11779-4283
Phone
(631) 751-3000
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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 752634-01 NY
Family Medicine Physician 207Q00000X F353498-01 NY Primary

Addresses

Primary practice location

501 Hawkins Ave
Ronkonkoma, NY 11779-4283

Mailing address

51 18TH Ave
Ronkonkoma, NY 11779-6203

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
I20250113002098 NY Practitioner - Nurse Practitioner 8224566674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
752634-01NYMDRegistered Nurse
F353498-01NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Jan 1, 2025 Accepting new patients

Locations

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

1 Research Rd
Ridge, NY 11961

501 Hawkins Ave
Ronkonkoma, NY 11779

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1629884077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 18TH AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 HAWKINS AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794283",
            "telephone_number": "631-751-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "SARA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "752634-01",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F353498-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

Verify at the official NPI Registry.