Organization Active NPI

D0E

  • Skilled Nursing Facility
  • Elmhurst, NY
National Provider Identifier
1750656021
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
443418-1 Issued in NY
Legal business name
D0E
Practice address
5040 Jacobus St
Elmhurst, NY 11373-3702
Phone
(718) 429-7006
Fax
(718) 429-6864
NPI assigned
Mar 19, 2012
Last updated
Mar 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Mrs. Maria Andres Daulo, RN
Title
Staff Nurse
Phone
(718) 429-7006

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 443418-1 NY
Skilled Nursing Facility 314000000X 443418-1 NY Primary

Addresses

Primary practice location

5040 Jacobus St
Elmhurst, NY 11373-3702

Mailing address

5040 Jacobus St
Elmhurst, NY 11373-3702
Phone (718) 429-7006

Other identifiers 1

IdentifierTypeStateIssuer
0440065MedicaidNY

National Provider Directory

National Provider Directory

Locations

5040 Jacobus St
Elmhurst, NY 11373
Phone (718) 205-6788

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1750656021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 JACOBUS ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733702",
            "telephone_number": "718-429-7006",
            "fax_number": "718-429-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 JACOBUS ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733702",
            "telephone_number": "718-429-7006",
            "fax_number": "718-429-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D0E",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "DAULO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ANDRES",
        "authorized_official_title_or_position": "STAFF NURSE",
        "authorized_official_telephone_number": "718-429-7006",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NY",
            "license": "443418-1",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "443418-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440065",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.