Individual provider Active NPI

Iveda Casseus

  • Licensed Practical Nurse
  • Spring Valley, NY
National Provider Identifier
1669629986
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
258403-1 Issued in NY
Practice address
3 N Hillside Ave
3 North Hillside Ave
Spring Valley, NY 10977-2331
Phone
(845) 352-6723
NPI assigned
Aug 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 258403-1 NY Primary

Addresses

Primary practice location

3 N Hillside Ave
3 North Hillside Ave
Spring Valley, NY 10977-2331

Mailing address

3 N Hillside Ave
3 North Hillside Ave
Spring Valley, NY 10977-2331
Phone (845) 352-6723

Other identifiers 1

IdentifierTypeStateIssuer
164W00000XMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
258403-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1669629986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 N HILLSIDE AVE",
            "address_2": "3 NORTH HILLSIDE AVE",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109772331",
            "telephone_number": "845-352-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 N HILLSIDE AVE",
            "address_2": "3 NORTH HILLSIDE AVE",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109772331",
            "telephone_number": "845-352-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSEUS",
        "first_name": "IVEDA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "258403-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164W00000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.