Individual provider Active NPI

Kelly Ann Herlihy, NP-C

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1649731639
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F343120-1 Issued in NY
Practice address
301 E 17TH St
New York, NY 10003-3804
Phone
(212) 598-6000
NPI assigned
Mar 31, 2019
Last updated
Jan 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F343120-1 NY Primary

Addresses

Primary practice location

301 E 17TH St
New York, NY 10003-3804

Mailing address

59 Fairfields LN
Huntington Station, NY 11746-2749
Phone (631) 252-2509

Other practice location 1

59 Fairfields Ln
Huntington Station, NY 11746-2749
Phone (631) 252-2509

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
I20200528002387 NY Order and Referring Only - Nurse Practitioner 6406277565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
343120NYMDEmergency Medicine Physician
F343120-1NYMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: kherlihy347191@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1649731639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 FAIRFIELDS LN",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117462749",
            "telephone_number": "631-252-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-598-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "59 Fairfields Ln",
            "address_purpose": "LOCATION",
            "city": "Huntington Station",
            "state": "NY",
            "postal_code": "117462749",
            "country_code": "US",
            "telephone_number": "631-252-2509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERLIHY",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-31",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F343120-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.