Individual provider Active NPI

Carol Markland, LPN

  • Primary Care Nurse Practitioner
  • Manorville, NY
National Provider Identifier
1659710994
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F311588-01 Issued in NY
Practice address
147 Village Cir W
Manorville, NY 11949-9671
Phone
(631) 874-8336
NPI assigned
Jun 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 310984 NY
Primary Care Nurse Practitioner 363LP2300X F311588-01 NY Primary

Addresses

Primary practice location

147 Village Cir W
Manorville, NY 11949-9671

Mailing address

54 Applegate Drive
Mastic
Mastic, NY 11950-9671
Phone (347) 664-1155

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
I20240523001372 NY Practitioner - Nurse Practitioner 0143662031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

11700 Main Rd
Suite 7
Mattituck, NY 11952-1525
Phone (631) 963-4770

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310984NYMDLicensed Practical Nurse
F311588-01NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 16, 2024 Accepting new patients
New York University CurrentSince Apr 16, 2024 Accepting new patients

Locations

11700 Main Rd
Ste 7
Mattituck, NY 11952
Phone (631) 963-4770

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

889 E Main St
Ste 308
Riverhead, NY 11901
Phone (631) 386-3500

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: cmarkland621769@nyumc.direct-ci.com

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1659710994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 APPLEGATE DRIVE",
            "address_2": "MASTIC",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119509671",
            "telephone_number": "347-664-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 VILLAGE CIR W",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119499671",
            "telephone_number": "631-874-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKLAND",
        "first_name": "CAROL",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "310984",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F311588-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manorville, NY

Sources for this page

Verify at the official NPI Registry.