Individual provider Active NPI

Sophia Maureen Colquhoun, AGNP

  • Nurse Practitioner
  • Astoria, NY
National Provider Identifier
1649964727
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F311362-01 Issued in NY
Practice address
2510 30TH Ave
Astoria, NY 11102-2448
Phone
(718) 932-1000
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F311362-01 NY Primary

Addresses

Primary practice location

2510 30TH Ave
Astoria, NY 11102-2448

Mailing address

2510 30TH Ave
Astoria, NY 11102-2448
Phone (718) 932-1000

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
I20250327001827 NY Practitioner - Nurse Practitioner 5092238303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
311362NYMDInternal Medicine Physician
F311362-01NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 1, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 1, 2025 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1649964727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "718-932-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "718-932-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLQUHOUN",
        "first_name": "SOPHIA",
        "middle_name": "MAUREEN",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F311362-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.