Individual provider Active NPI

Angela Victoriano Resurreccion, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Oaks, NY
National Provider Identifier
1639698293
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402302 Issued in NY
Practice address
7559 263Rd St
Glen Oaks, NY 11004-1150
Phone
(718) 470-8100
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402302 NY Primary

Addresses

Primary practice location

7559 263Rd St
Glen Oaks, NY 11004-1150

Mailing address

2360 Milburn Ave
Baldwin, NY 11510-3322
Phone (718) 791-5402

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
I20181205003468 NY Practitioner - Nurse Practitioner 0840534673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

75 -59
Glen Oaks, NY 11004-1150
Phone (718) 470-8100

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
402302NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Aug 30, 2018 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 30, 2018 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

7559 263rd St
Glen Oaks, NY 11004
Phone (718) 470-8005

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1639698293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MILBURN AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103322",
            "telephone_number": "718-791-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7559 263RD ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041150",
            "telephone_number": "718-470-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESURRECCION",
        "first_name": "ANGELA",
        "middle_name": "VICTORIANO",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

Verify at the official NPI Registry.