Nadia Candice Patrick, REGISTERED NURSE

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

349789 Issued in NY

Practice address

140 Old Orangeburg Rd
Orangeburg, NY 10962-1157

Phone

(845) 359-1000

NPI assigned

Jan 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nadia Candice Johnson Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1750898482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 OLD ORANGEBURG RD",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109621157",
            "telephone_number": "845-359-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 OLD ORANGEBURG RD",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109621157",
            "telephone_number": "845-359-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "NADIA",
        "middle_name": "CANDICE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "599241",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "349789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349789",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADIA",
            "last_name": "JOHNSON",
            "middle_name": "CANDICE",
            "credential": "REGISTERED NURSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jane Osuna, LCSW
• Lisa M Palko
• Jaehyun Rita Park, OTR/L
• Sung Soo Park, M.D.
• Kunjal Yeshesh Patel
• Marcel Perl, MD
• Christina L. Petersen, D.C.
• Mary Petrovski, RPH
• Aniamma Philip
• Sicily Philip, RN

• Family Medicine Physician in Orangeburg, NY
• Providers in Orangeburg, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.