Individual provider Active NPI

Uliana Petrova

  • Pediatric Nurse Practitioner
  • Smithtown, NY
National Provider Identifier
1669142402
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F383292 Issued in NY
Practice address
8 Alberta CT
Smithtown, NY 11787-4709
Phone
(631) 599-1765
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F383292 NY Primary

Addresses

Primary practice location

8 Alberta CT
Smithtown, NY 11787-4709

Mailing address

8 Alberta CT
Smithtown, NY 11787-4709
Phone (631) 599-1765

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
I20221223000306 NY Practitioner - Nurse Practitioner 3678943214 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F383292NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Lij, Urgent Care, P.C. CurrentSince Oct 24, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince Sep 17, 2022 Accepting new patients
North Shore - Lij Medical PC CurrentSince Sep 17, 2022 Accepting new patients

Locations

98 Jericho Tpke
Commack, NY 11725
Phone (631) 387-4355

1950 Jericho Tpke
East Northport, NY 11731
Phone (631) 238-3065

5828 99th St
Flushing, NY 11368
Phone (718) 502-9867

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

377 S Oyster Bay Rd
Plainview, NY 11803
Phone (516) 537-9061

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: uliana.petrova@ghuc.eclinicaldirectplus.com

Organizations & group practices 3

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1669142402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 ALBERTA CT",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874709",
            "telephone_number": "631-599-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 ALBERTA CT",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874709",
            "telephone_number": "631-599-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROVA",
        "first_name": "ULIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.