Karin A. Antaky, NP
Individual provider Active NPI Family Nurse Practitioner · Mineola, NY
NPI 1760628234 · NPPES record last updated Jan 20, 2014
Key facts
- NPI
- 1760628234
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 333110 (NY)
- Practice address
- 200 Old Country Rd
Suite 370
Mineola, NY 11501-4235 - Phone
- (516) 663-4525
- Fax
- (516) 663-4532
- NPI assigned
- Jan 5, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090319000108 | NY | Practitioner - Nurse Practitioner | 5395802334 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Medical Services, P.C. | Current |
Accepting new patients |
Locations
245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141
755 Hempstead Tpke
Uniondale, NY 11553
Phone (516) 565-1900
1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 333110 | NY | Yes |
Addresses
Primary practice location
200 Old Country Rd
Suite 370
Mineola, NY 11501-4235
Mailing address
200 Old Country Rd
Suite 370
Mineola, NY 11501-4235
Phone (516) 663-4525
Other providers in Mineola, NY
- Alyssa Rose Angelillo
- Moris Alejandro Angulo
- Shaiba Anil
- Abel Aniyankunju
- Christopher Naser Annabi
- Ronny Antony
- Zuha Asghar Anwar
- Anastasiya Apanasyuk
- Mark Carl Tabliago Apostol
- Maria Priscila C. Arafiles
All providers in Mineola, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.