Individual provider Active NPI

Irisa Mezore

  • Urgent Care Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1760253702
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Practice address
7015 3Rd Ave
Brooklyn, NY 11209-1306
Phone
(917) 859-7331
NPI assigned
Jan 9, 2024
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X F353766 NY

Addresses

Primary practice location

7015 3Rd Ave
Brooklyn, NY 11209-1306

Mailing address

7015 3Rd Ave
Brooklyn, NY 11209-1306
Phone (917) 859-7331

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
I20250310002688 NY Practitioner - Nurse Practitioner 9436670247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7015 3Rd Ave
Brooklyn, NY 11209-1306
Phone (718) 333-5464

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F353766NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Ridge Family Health NP, PLLC Multi-Specialty CurrentSince Dec 30, 2024 Accepting new patients

Locations

7015 3rd Ave
Brooklyn, NY 11209
Phone (718) 333-5464

Networks

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

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, 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": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1760253702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091306",
            "telephone_number": "917-859-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091306",
            "telephone_number": "917-859-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZORE",
        "first_name": "IRISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.