Individual provider Active NPI

Ilona Eva Criner, PMHNP, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Island City, NY
National Provider Identifier
1740836675
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F406021-01 Issued in NY
Practice address
2976 Northern Blvd FL 2
Long Island City, NY 11101-2829
Phone
(914) 479-2779
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F406021-01 NY Primary

Addresses

Primary practice location

2976 Northern Blvd FL 2
Long Island City, NY 11101-2829

Mailing address

2976 Northern Blvd
Long Island City, NY 11101-2822
Phone (212) 691-7554

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
I20241105003457 NY Practitioner - Nurse Practitioner 1759815301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Fortune Society IncGroup PAC ID 0042479263, 5 clinicians

Practice addresses (Care Compare)

2976 Northern Blvd
FL 2
Long Island City, NY 11101-2829
Phone (212) 691-7554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Fortune Society CurrentSince Sep 29, 2024 Accepting new patients
The Fortune Society Inc. CurrentSince Aug 28, 2024 Accepting new patients

Locations

2976 Northern Blvd
Long Island City, NY 11101
Phone (212) 691-7554

2976 Northern Blvd
Fl 2
Long Island City, NY 11101
Phone (212) 691-7554

Organizations & group practices 2

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1740836675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2976 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012822",
            "telephone_number": "212-691-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2976 NORTHERN BLVD FL 2",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012829",
            "telephone_number": "914-479-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRINER",
        "first_name": "ILONA",
        "middle_name": "EVA",
        "name_prefix": "Dr.",
        "credential": "PMHNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F406021-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.