Active NPI
Mary Alice Visnefsky, RN
- Registered Nurse
- Riverhead, NY
National Provider Identifier
1639715170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 322578-1
- Practice address
- 300 Center Dr
Riverhead, NY 11901-3393 - Phone
- (631) 852-2680
- NPI assigned
- Nov 19, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 322578-1 | NY | Primary |
Addresses
Primary practice location
300 Center Dr
Riverhead, NY 11901-3393
Mailing address
17 Mahogany Rd
Rocky Point, NY 11778-9217
Phone (516) 635-7521
Other names 1
- Ms. Mary Alice Vermaelen
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 322578-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1639715170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 MAHOGANY RD",
"city": "ROCKY POINT",
"state": "NY",
"postal_code": "117789217",
"telephone_number": "516-635-7521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 CENTER DR",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119013393",
"telephone_number": "631-852-2680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISNEFSKY",
"first_name": "MARY",
"middle_name": "ALICE",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-19",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "322578-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "VERMAELEN",
"middle_name": "ALICE",
"prefix": "MS.",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.