Individual provider Active NPI

Peggy McCormack, NP

  • Nurse Practitioner
  • Manhasset, NY
National Provider Identifier
1770602864
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F302966 Issued in NY
Practice address
300 Community Dr
Manhasset, NY 11030-3816
Phone
(516) 562-4970
NPI assigned
Mar 28, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 402131 NY
Nurse Practitioner 363L00000X F302966 NY Primary

Addresses

Primary practice location

300 Community Dr
Manhasset, NY 11030-3816

Mailing address

972 Brush Hollow Rd
Westbury, NY 11590-1740
Phone (516) 876-5555

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
I20090108000227 NY Practitioner - Nurse Practitioner 8123181732 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
402131NYMDMedical-Surgical Registered Nurse
302966NYMDUrology Physician
F302966NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 21, 2016 Accepting new patients

Locations

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

300 Community Dr
Manhasset, NY 11030

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1770602864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-5555",
            "fax_number": "516-876-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "PEGGY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "402131",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F302966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.