Individual provider Active NPI

Courtney Palazzolo

  • Adult Health Nurse Practitioner
  • North Babylon, NY
National Provider Identifier
1649008871
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311901 Issued in NY
Practice address
1231 Deer Park Ave
North Babylon, NY 11703-3104
Phone
(631) 667-0388
Fax
(631) 968-7705
NPI assigned
Jul 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311901 NY Primary

Addresses

Primary practice location

1231 Deer Park Ave
North Babylon, NY 11703-3104

Mailing address

1231 Deer Park Ave
North Babylon, NY 11703-3104
Phone (631) 667-0388

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
I20241216000897 NY Practitioner - Nurse Practitioner 8123554052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Island Comprehensive Medical Care PLLCGroup PAC ID 3678731908, 41 clinicians

Practice addresses (Care Compare)

1231 Deer Park Ave
North Babylon, NY 11703-3104
Phone 6316670388612

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311901NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Comprehensive Medical Care PLLC CurrentSince Jan 6, 2025 Accepting new patients
Shahzad Iqbal Physician PLLC PastSince Dec 15, 2024 Accepting new patients

Locations

350 W Montauk Hwy
Lindenhurst, NY 11757
Phone (631) 226-0388

1231 Deer Park Ave
North Babylon, NY 11703
Phone 6316670388612

555 Little East Neck Rd N
West Babylon, NY 11704
Phone (631) 587-9355

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDHCCD
  • Direct secure messaging: courtney.palazzolo@lcmc.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1649008871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033104",
            "telephone_number": "631-667-0388",
            "fax_number": "631-968-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033104",
            "telephone_number": "631-667-0388",
            "fax_number": "631-968-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZOLO",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

Verify at the official NPI Registry.