Samantha M Ferazzoli

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

309884 Issued in NY

Practice address

207 Glen Cove Ave
Sea Cliff, NY 11579-1455

Phone

(516) 676-1742

NPI assigned

May 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• North Coast Internal Medicine, P.C.

  • Internal Medicine Physician
  • Sea Cliff, NY
  • NPI 1164600987
  Medicare reassignment NPD

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1700408762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 GLEN COVE AVE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115791455",
            "telephone_number": "516-592-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 GLEN COVE AVE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115791455",
            "telephone_number": "516-676-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERAZZOLI",
        "first_name": "SAMANTHA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "672200",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle Ryder Derienzis, LCSW
• Dr Elsie Witt-Bockler, Physician PC
• Nina Ehrlich-Foley
• Kathleen Emmett, RDN
• Lacey Fater, PA-C
• Jennie Fiddler, CAT
• Eileen Mary Kathryn Fontanetta, M.D. F.A.A.P.,M.P.H.
• Jo-Ellen Foti, LCSW
• Amanda Gabel, LMSW
• Charles A Gambino, DO

• Adult Health Nurse Practitioner in Sea Cliff, NY
• Providers in Sea Cliff, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.