Individual provider Active NPI

Caroline Jill Scalamandre

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1679033864
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F431423-1 Issued in NY
Practice address
177 Fort Washington Ave
MHB 5 Garden North Room 5-435
New York, NY 10032
Phone
(212) 305-9564
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F431423-1 NY Primary

Addresses

Primary practice location

177 Fort Washington Ave
MHB 5 Garden North Room 5-435
New York, NY 10032

Mailing address

630 W 168TH St # 4
New York, NY 10032-3725
Phone (212) 305-9564

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
I20190723001359 NY Practitioner - Nurse Practitioner 9931435302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F431423-1NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince May 29, 2019 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince May 29, 2019 Accepting new patients

Locations

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

177 Fort Washington Ave
Rm 5435
New York, NY 10032
Phone (212) 305-2009

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

Networks

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

Interoperability endpoints

  • Direct secure messaging: cas9259@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1679033864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "address_2": "MHB 5 GARDEN NORTH ROOM 5-435",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-305-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALAMANDRE",
        "first_name": "CAROLINE",
        "middle_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F431423-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.