Individual provider Active NPI

Victoria Lynn Barberer, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Manorville, NY
National Provider Identifier
1659503662
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F311835 Issued in NY
Practice address
21 Pondway Apt 4
Manorville, NY 11949-2241
Phone
(631) 576-6737
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 618903 NY
Pediatric Registered Nurse 163WP0200X 618903 NY
Licensed Practical Nurse 164W00000X 264944 NY
Adult Health Nurse Practitioner 363LA2200X F311835 NY Primary

Addresses

Primary practice location

21 Pondway Apt 4
Manorville, NY 11949-2241

Mailing address

21 Pondway Apt 4
Manorville, NY 11949-2241
Phone (631) 576-6737

Other names 1

  • Victoria Lynn Barberer Professional 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
I20241119003608 NY Practitioner - Nurse Practitioner 6901331503 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
618903NYMDRegistered Nurse
264944NYMDLicensed Practical Nurse
F311835NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Sep 16, 2024 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

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": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1659503662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PONDWAY APT 4",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492241",
            "telephone_number": "631-576-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PONDWAY APT 4",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492241",
            "telephone_number": "631-576-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBERER",
        "first_name": "VICTORIA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "618903",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "618903",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "264944",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "BARBERER",
            "middle_name": "LYNN",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Manorville, NY

Sources for this page

Verify at the official NPI Registry.