Active NPI
Charles E Pluviose
- Registered Nurse
- Staten Island, NY
National Provider Identifier
1649866773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 806847
- Practice address
- 12 Lyle CT
Staten Island, NY 10306-1142 - Phone
- (917) 763-8384
- NPI assigned
- Dec 13, 2020
- Sex
- Male
- 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 | 806847 | NY | Primary |
Addresses
Primary practice location
12 Lyle CT
Staten Island, NY 10306-1142
Mailing address
401 Wildwood CT
East Stroudsburg, PA 18301-8580
Phone (570) 856-0917
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
| License | State | Type | Specialty |
|---|---|---|---|
| 806847 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1649866773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 WILDWOOD CT",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183018580",
"telephone_number": "570-856-0917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 LYLE CT",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103061142",
"telephone_number": "917-763-8384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLUVIOSE",
"first_name": "CHARLES",
"middle_name": "E",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-13",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "806847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.