Individual provider Active NPI

Mark Winkler, FNP

  • Family Nurse Practitioner
  • Lawrence, NY
National Provider Identifier
1679739379
Registry record updated Nov 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346040 Issued in NY
Practice address
625 Rockaway Tpke
Lawrence, NY 11559-1029
Phone
(516) 871-3003
NPI assigned
Aug 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 346040 NY Primary

Addresses

Primary practice location

625 Rockaway Tpke
Lawrence, NY 11559-1029

Mailing address

1488 Deer Park Ave # 256
North Babylon, NY 11703-1208

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
346040NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638057600000",
    "number": "1679739379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 DEER PARK AVE # 256",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117031208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ROCKAWAY TPKE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591029",
            "telephone_number": "516-871-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINKLER",
        "first_name": "MARK",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2021-11-28",
        "certification_date": "2021-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2021; 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.