Individual provider Active NPI

Kamlawattie Basdeo

  • General Practice Registered Nurse
  • South Ozone Park, NY
National Provider Identifier
1639752694
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
467449-1 Issued in NY
Practice address
13054 116TH St
South Ozone Park, NY 11420-2320
Phone
(718) 738-8965
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 467449-1 NY Primary

Addresses

Primary practice location

13054 116TH St
South Ozone Park, NY 11420-2320

Mailing address

590 Avenue of the Americas
New York, NY 10011-2022
Phone (212) 886-4099

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

State licenses

LicenseStateTypeSpecialty
467449-1NYMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1639752694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 AVENUE OF THE AMERICAS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112022",
            "telephone_number": "212-886-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13054 116TH ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202320",
            "telephone_number": "718-738-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASDEO",
        "first_name": "KAMLAWATTIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "467449-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.