Individual provider Active NPI

Ayanna Wesley, NP

  • Adult Health Nurse Practitioner
  • Port Jefferson Station, NY
National Provider Identifier
1669364717
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
312366 Issued in NY
Practice address
1360 Route 112
Port Jefferson Station, NY 11776-3078
Phone
(631) 764-1976
NPI assigned
Jul 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 312366 NY Primary

Addresses

Primary practice location

1360 Route 112
Port Jefferson Station, NY 11776-3078

Mailing address

PO Box 35
Ridge, NY 11961-0035

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
I20260213004103 NY Practitioner - Nurse Practitioner 9234619776 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dinesh Sethi Physician PCGroup PAC ID 3678703998, 8 clinicians
Progressive Care Medical Group PLLCGroup PAC ID 7113298209, 45 clinicians

Practice addresses (Care Compare)

305 Locust Ave
Oakdale, NY 11769-1652
Phone (631) 218-5900

395 Sunken Meadow Rd
Kings Park, NY 11754-1000
Phone (631) 269-5800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312366NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dinesh Sethi Physician PC CurrentSince Dec 21, 2025 Accepting new patients

Locations

305 Locust Ave
Oakdale, NY 11769
Phone (631) 218-5900

14310 20th Ave
Whitestone, NY 11357
Phone (718) 961-1212

1521 Straight Path
Wyandanch, NY 11798
Phone (631) 643-3800

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": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1669364717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119610035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763078",
            "telephone_number": "631-764-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESLEY",
        "first_name": "AYANNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "312366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.