Individual provider Active NPI

Michelle Brown, AGNP-C

  • Gerontology Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1790153005
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
308515 Issued in NY
Practice address
3000 Marcus Ave Ste 2W15
New Hyde Park, NY 11042-1005
Phone
(855) 201-4988
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN182422 GA
Gerontology Nurse Practitioner 363LG0600X 308515 NY Primary

Addresses

Primary practice location

3000 Marcus Ave Ste 2W15
New Hyde Park, NY 11042-1005

Mailing address

616 FM 1960 Rd W
Ste 230
Houston, TX 77090-3024
Phone (877) 749-7428

Other practice location 1

70 Homestead Way
Covington, GA 30014-7608
Phone (845) 591-2799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160509002447 GA Practitioner - Nurse Practitioner 1153610449 Reassigns benefits to 1 organization
I20200305001167 NY Practitioner - Nurse Practitioner 1153610449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Allied Medical of Ny PCGroup PAC ID 9335590751, 11 clinicians

Practice addresses (Care Compare)

1 Old Country Rd
Suite 285
Carle Place, NY 11514-1824
Phone (973) 942-6005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
308515NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Medical Services of New York, PLLC CurrentSince Mar 18, 2025 Accepting new patients
Post-Acute Physicians of Georgia P.C. CurrentSince Mar 23, 2016 Accepting new patients
Allied Medical of Ny PC CurrentSince Jan 1, 2024 Accepting new patients
World Chiropractic Incorporated Past Accepting new patients

Locations

450 N Candler St
Decatur, GA 30030
Phone (404) 501-6100

2121 Fountain Dr
Ste D
Snellville, GA 30078
Phone (770) 674-4888

510 Hamburg Tpke
Ste 102
Wayne, NJ 07470
Phone (973) 595-7555

1 Old Country Rd
Ste 285
Carle Place, NY 11514
Phone (973) 942-6005

1802 Petracca Pl
Ste 103
Whitestone, NY 11357
Phone (646) 722-7610

616 FM 1960 Rd W
Ste 230
Houston, TX 77090
Phone (832) 484-8100

Interoperability endpoints

  • Direct secure messaging: mibrown@landmarkhealth-direct.org

Organizations & group practices 4

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1790153005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 FM 1960 RD W",
            "address_2": "STE 230",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903024",
            "telephone_number": "877-749-7428",
            "fax_number": "512-628-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MARCUS AVE STE 2W15",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421005",
            "telephone_number": "855-201-4988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Homestead Way",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300147608",
            "country_code": "US",
            "telephone_number": "845-591-2799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHELLE",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN182422",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "308515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.