Individual provider Active NPI

Andreza Martinta, RN

  • Registered Nurse
  • Mastic Beach, NY
National Provider Identifier
1780023366
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
670172-1 Issued in NY
Practice address
74 Mill Dr
Mastic Beach, NY 11951-1403
Phone
(516) 323-9418
NPI assigned
Jun 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 670172-1 NY Primary

Addresses

Primary practice location

74 Mill Dr
Mastic Beach, NY 11951-1403

Mailing address

71 Charles St
Apt 1a
Mineola, NY 11501-1905
Phone (516) 323-9418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
670172-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1780023366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 CHARLES ST",
            "address_2": "APT 1A",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115011905",
            "telephone_number": "516-323-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 MILL DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119511403",
            "telephone_number": "516-323-9418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINTA",
        "first_name": "ANDREZA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "670172-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mastic Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.