Irena Hovhannisyan
Individual provider Active NPI Family Nurse Practitioner · Staten Island, NY
NPI 1699520304 · NPPES record last updated Apr 17, 2024
Key facts
- NPI
- 1699520304
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F353707 (NY)
- Practice address
- 3974 Amboy Rd Ste 302
Staten Island, NY 10308-2414 - Phone
- (718) 967-1071
- NPI assigned
- Apr 17, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Urban Family Practice PC
Practice addresses (Care Compare)
322 Linden Blvd
Brooklyn, NY 11226-3579
Phone (347) 694-7434
3974 Amboy Rd
Suite 302
Staten Island, NY 10308-2414
Phone (718) 967-1071
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251107002658 | NY | Practitioner - Nurse Practitioner | 6507356607 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F353707 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Annadale NP in Family Health P.C. | Current |
Accepting new patients | |
| My Medical PC | Current |
Accepting new patients |
Locations
110 Henderson Ave
Staten Island, NY 10301
Phone (516) 295-1924
3974 Amboy Rd
Ste 302
Staten Island, NY 10308
Phone (347) 730-4606
Interoperability endpoints
- ihovhannisyan@cinq-nyipa.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F353707 | NY | Yes |
Addresses
Primary practice location
3974 Amboy Rd Ste 302
Staten Island, NY 10308-2414
Mailing address
52 Eagan Ave
Staten Island, NY 10312-4104
Phone (646) 406-9286
Other providers in Staten Island, NY
- Mehorunnesa Hossain
- Nadiv Hossain
- Hamida Hossaini
- Jason Hou
- House of Wellness Mental Health Counseling, PLLC
- Timothy Howard Jr.
- Anne Howard
- Donaire H Howard
- Maureen Howard
- Samantha Howard
All providers in Staten Island, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.