Individual provider Active NPI

Holly Anne Carlson, NP

  • Critical Care Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1770204000
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
432424 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-7300
NPI assigned
Sep 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 432424 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

2138 Caton Ave Apt 605
Brooklyn, NY 11226-8099
Phone (248) 978-5702

Other names 1

  • Holly Anne Grosso Former name

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
I20230208002050 NY Practitioner - Nurse Practitioner 0446622070 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 26, 2022 Accepting new patients
New York University CurrentSince Oct 26, 2022 Accepting new patients

Locations

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: hcarlson495708@nyumc.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1770204000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 CATON AVE APT 605",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112268099",
            "telephone_number": "248-978-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "HOLLY",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "NY",
            "license": "432424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "GROSSO",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.