Individual provider Active NPI

Marcia Nieves

  • Adult Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1780113134
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F308096 Issued in NY
Practice address
222 Bard Avenue
Staten Island, NY 10310
Phone
(718) 442-8632
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F308096 NY Primary

Addresses

Primary practice location

222 Bard Avenue
Staten Island, NY 10310

Mailing address

222 Bard Ave
Staten Island, NY 10310-1658
Phone (718) 442-8632

Other practice location 1

355 Bard Ave
Staten Island, NY 10310-1664
Phone (718) 442-8632

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
I20200225000529 NY Practitioner - Nurse Practitioner 4082041470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

1200 Manor Rd
RM 741
Staten Island, NY 10314-7027
Phone (718) 818-1200

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F308096NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Dec 30, 2019 Accepting new patients
Amboy Medical Practice PC CurrentSince Dec 30, 2019 Accepting new patients

Locations

1200 Manor Rd
Ste 741
Staten Island, NY 10314

1487 Richmond Rd
Staten Island, NY 10304
Phone (718) 979-3643

217 Rose Ave
Staten Island, NY 10306
Phone (718) 351-0901

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

2935 Veterans Rd W
Staten Island, NY 10309
Phone (718) 273-5550

2935 Veterans Rd W
Ste H
Staten Island, NY 10309
Phone (718) 818-4361

1200 Manor Rd
Rm 741
Staten Island, NY 10314
Phone (718) 818-1200

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

4360 Hylan Blvd
Staten Island, NY 10312
Phone (718) 818-4360

Networks

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

Interoperability endpoints

  • Direct secure messaging: marcia.nieves.1@19656.direct.athenahealth.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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780113134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101658",
            "telephone_number": "718-442-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BARD AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10310",
            "telephone_number": "718-442-8632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Bard Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103101664",
            "country_code": "US",
            "telephone_number": "718-442-8632",
            "fax_number": "718-442-8632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "MARCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.