NPIMap

Individual provider Active NPI

Michelle Byrne, ANP

  • Adult Health Nurse Practitioner
  • Port Jefferson, NY
National Provider Identifier
1750769808
Registry record updated May 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307048 Issued in NY
Practice address
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone
(631) 473-1320
Fax
(631) 686-7972
NPI assigned
May 9, 2015
Last updated
May 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F307048 NY Primary

Addresses

Primary practice location

75 N Country Rd
Port Jefferson, NY 11777-2119

Mailing address

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151026000160 NY Practitioner - Nurse Practitioner 1456660877 Reassigns benefits to 3 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
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1174 Route 112
Port Jefferson Station, NY 11776-8033
Phone (631) 642-9090

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F307048NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Apr 1, 2017 Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
CHS Physician Partners, PC CurrentSince Apr 1, 2017 Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital CurrentSince Feb 10, 2025 Accepting new patients

Locations

100 Highlands Blvd
#9
Port Jefferson, NY 11777
Phone (631) 686-7809

1174 Route 112
Port Jefferson Station, NY 11776
Phone (631) 509-1730

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

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

Interoperability endpoints

  • Direct secure messaging: mbyrne105716@direct-chsli.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1431129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431129600000",
    "number": "1750769808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-473-1320",
            "fax_number": "631-686-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "MICHELLE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-09",
        "last_updated": "2015-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.