Individual provider Active NPI

Michelle Turner, C.P.N.P., I.B.C.L.C.

  • Pediatric Nurse Practitioner
  • Plainview, NY
National Provider Identifier
1760503387
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F381122 Issued in NY
Practice address
998 Old Country Rd Ste C
Ste. 159
Plainview, NY 11803-4936
Phone
(516) 502-5255
Fax
(886) 253-3425
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F381122 NY Primary

Addresses

Primary practice location

998 Old Country Rd Ste C
Ste. 159
Plainview, NY 11803-4936

Mailing address

998 Old Country Rd Ste C
Ste. 159
Plainview, NY 11803-4936
Phone (516) 502-5255

Other identifiers 1

IdentifierTypeStateIssuer
02197473MedicaidNY

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
I20120928000123 NY Practitioner - Nurse Practitioner 6002065489 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F381122NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: mturner19565@direct.optum.com

Organizations & group practices 3

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1760503387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 OLD COUNTRY RD STE C",
            "address_2": "STE. 159",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034936",
            "telephone_number": "516-502-5255",
            "fax_number": "886-253-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 OLD COUNTRY RD STE C",
            "address_2": "STE. 159",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034936",
            "telephone_number": "516-502-5255",
            "fax_number": "886-253-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNER",
        "first_name": "MICHELLE",
        "credential": "C.P.N.P., I.B.C.L.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02197473",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.