Individual provider Active NPI

Lynn Ann Estelle, CPNP

  • Pediatric Nurse Practitioner
  • Babylon, NY
National Provider Identifier
1639330194
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
344739-1 Issued in NY
Practice address
655 Deer Park Ave
Babylon, NY 11702-1314
Phone
(631) 321-2220
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 344739-1 NY Primary

Addresses

Primary practice location

655 Deer Park Ave
Babylon, NY 11702-1314

Mailing address

655 Deer Park Ave
Babylon, NY 11702-1314
Phone (631) 321-2220

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
I20111104000534 NY Practitioner - Nurse Practitioner 7315110467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Pediatric Services PCGroup PAC ID 7618151887, 9 clinicians

Practice addresses (Care Compare)

655 Deer Park Ave
Babylon, NY 11702-1314
Phone (631) 321-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
344739-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pediatric Services, P.C. CurrentSince Sep 4, 2011 Accepting new patients
Samaritan Medical Services, P.C. CurrentSince Feb 7, 2018 Accepting new patients

Locations

655 Deer Park Ave
Babylon, NY 11702
Phone (631) 321-2100

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Interoperability endpoints

  • Direct secure messaging: lestelle40713@direct-chsli.net

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": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1639330194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 DEER PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117021314",
            "telephone_number": "631-321-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 DEER PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117021314",
            "telephone_number": "631-321-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTELLE",
        "first_name": "LYNN",
        "middle_name": "ANN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "344739-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

Verify at the official NPI Registry.