Individual provider Active NPI

Autumn Drake

  • Infusion Therapy Registered Nurse
  • Melville, NY
National Provider Identifier
1740155290
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
License
755372 Issued in NY
Practice address
265 Broadhollow Rd Ste 201
Melville, NY 11747-4833
Phone
(888) 722-2072
NPI assigned
Oct 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WI0500X 755372 NY Primary

Addresses

Primary practice location

265 Broadhollow Rd Ste 201
Melville, NY 11747-4833

Mailing address

178 Washington St
Newburgh, NY 12550-6242

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
755372NYMDInfusion Therapy Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1740155290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 WASHINGTON ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125506242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 BROADHOLLOW RD STE 201",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474833",
            "telephone_number": "888-722-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "AUTUMN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "NY",
            "license": "755372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.