Individual provider Active NPI

Kabelys Sierra Solano

  • Gerontology Nurse Practitioner
  • New York, NY
National Provider Identifier
1679387476
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG10240078 Issued in NJ
Practice address
622 W 168TH St FL 14
New York, NY 10032-3720
Phone
(929) 656-1215
Fax
(212) 305-4343
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG10240078 NJ Primary

Addresses

Primary practice location

622 W 168TH St FL 14
New York, NY 10032-3720

Mailing address

3060 Edwin Ave Apt 5F
Fort Lee, NJ 07024-4808
Phone (718) 502-7449

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
AG10240078NJMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1679387476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 EDWIN AVE APT 5F",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244808",
            "telephone_number": "718-502-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "929-656-1215",
            "fax_number": "212-305-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA SOLANO",
        "first_name": "KABELYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "AG10240078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.