Individual provider Active NPI

Sabrina Mackittrick, NP

  • Adult Health Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1699196683
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F306680-1 Issued in NY
Practice address
27005 76TH Ave
Emergency Department
New Hyde Park, NY 11040-1402
Phone
(718) 470-7501
NPI assigned
Dec 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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 F306680-1 NY Primary

Addresses

Primary practice location

27005 76TH Ave
Emergency Department
New Hyde Park, NY 11040-1402

Mailing address

91 Indiana Ave
Long Beach, NY 11561-1225
Phone (917) 497-9930

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
I20140929000275 NY Practitioner - Nurse Practitioner 9234359175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sisselman Medical Group PCGroup PAC ID 4284715269, 5 clinicians

Practice addresses (Care Compare)

627 Broadway
Massapequa, NY 11758-5031
Phone (516) 308-4040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F306680-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sisselman Medical Group, PC CurrentSince Jun 20, 2016 Accepting new patients

Locations

627 Broadway
Ste 1
Massapequa, NY 11758
Phone (516) 308-4040

Interoperability endpoints

  • Direct secure messaging: sabrina.mackittrick@sissmedgroup.eclinicaldirectplus.com

Organizations & group practices 1

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": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1699196683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 INDIANA AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115611225",
            "telephone_number": "917-497-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-470-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKITTRICK",
        "first_name": "SABRINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306680-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.