Individual provider Active NPI

Alexandra Gutman, NP

  • Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1710395348
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
306840 Issued in NY
Practice address
900 Franklin Ave
Valley Stream, NY 11580-2145
Phone
(516) 562-4280
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 306840 NY Primary

Addresses

Primary practice location

900 Franklin Ave
Valley Stream, NY 11580-2145

Mailing address

900 Franklin Ave
Valley Stream, NY 11580-2145
Phone (516) 562-4280

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
I20180820002056 NY Practitioner - Nurse Practitioner 5597014860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

221 Jericho Turnpike
Syosset, NY 11791-4515
Phone (516) 496-6500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306840NYMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Oct 21, 2020 Accepting new patients
Mount Sinai School of Medicine Nurse Practitioner CurrentSince Feb 1, 2019 Accepting new patients
Mount Sinai School of Medicine Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Oct 21, 2020 Accepting new patients
Mount Sinai School of Medicine CurrentSince Feb 1, 2019 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

70 E 90th St
New York, NY 10128
Phone (212) 426-0190

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

300 Community Dr
Plandome, NY 11030

2 Lincoln Ave
Rockville Ctr, NY 11570
Phone (516) 390-2850

221 Jericho Tpke
Syosset, NY 11791
Phone (516) 496-6400

1 S Central Ave
Valley Stream, NY 11580
Phone (516) 632-3300

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 5

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1710395348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802145",
            "telephone_number": "516-562-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802145",
            "telephone_number": "516-562-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "306840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.