Individual provider Active NPI

Stephanie Nicole Gregory

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1750839924
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
718658 Issued in NY
Practice address
130 E 77TH St FL 10
New York, NY 10075-1851
Phone
(212) 443-4450
NPI assigned
Sep 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 718658 NY Primary

Addresses

Primary practice location

130 E 77TH St FL 10
New York, NY 10075-1851

Mailing address

1307 1/2 Davis Ave
Birmingham, MI 48009-2075

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
I20180716000018 NY Practitioner - Nurse Practitioner 8921355421 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
341145NYMDDiagnostic Radiology Physician
718658NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City Care Family Practice, P.C. CurrentSince Apr 16, 2018 Accepting new patients

Locations

160 E 32nd St
Ste 102
New York, NY 10016
Phone (212) 545-1800

461 Park Ave S
Fl 9
New York, NY 10016
Phone (212) 545-1888

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGDFAA

Organizations & group practices 1

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": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1750839924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 1/2 DAVIS AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480092075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E 77TH ST FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751851",
            "telephone_number": "212-443-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "718658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.