Individual provider Active NPI

Virginia McHale

  • Adult Health Nurse Practitioner
  • Commack, NY
National Provider Identifier
1649653270
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307329-1 Issued in NY
Practice address
6080 Jericho Tpke
Suite 314
Commack, NY 11725-2850
Phone
(631) 462-2200
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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 F307329-1 NY Primary

Addresses

Primary practice location

6080 Jericho Tpke
Suite 314
Commack, NY 11725-2850

Mailing address

6080 Jericho Tpke
Suite 314
Commack, NY 11725-2850
Phone (631) 462-2200

Other names 1

  • Virginia Nicholes Former name

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
I20160421001526 NY Practitioner - Nurse Practitioner 7012215205 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
307329NYMDLicensed Practical Nurse
F307329-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Condon Medical PC CurrentSince Feb 8, 2016 Accepting new patients

Locations

6080 Jericho Tpke
Commack, NY 11725
Phone (631) 462-2200

6080 Jericho Tpke
Ste 314
Commack, NY 11725
Phone (631) 462-2200

6080 Jericho Tpke
Ste 316
Commack, NY 11725

1715 N Ocean Ave
Medford, NY 11763
Phone (631) 462-2200

Interoperability endpoints

  • Direct secure messaging: virginia.nicholes.1@1427.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1427/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1649653270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6080 JERICHO TPKE",
            "address_2": "SUITE 314",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252850",
            "telephone_number": "631-462-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 JERICHO TPKE",
            "address_2": "SUITE 314",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252850",
            "telephone_number": "631-462-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCHALE",
        "first_name": "VIRGINIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307329-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "NICHOLES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.