Active NPI
Sorange Pena Lara, RN
- Registered Nurse
- Spring Valley, NY
National Provider Identifier
1790597474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 973024
- Practice address
- 42 N Main St
Spring Valley, NY 10977-4906 - Phone
- (844) 828-2666
- NPI assigned
- Jan 21, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 973024 | NY | Primary |
Addresses
Primary practice location
42 N Main St
Spring Valley, NY 10977-4906
Mailing address
2 North St Apt D5
Mount Vernon, NY 10550-1140
Phone (718) 612-8147
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
| License | State | Type | Specialty |
|---|---|---|---|
| 973024 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Glove Community Care, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Home Health Agency
- Brick, NJ
- NPI 1538371778
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737417600000",
"number": "1790597474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 NORTH ST APT D5",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105501140",
"telephone_number": "718-612-8147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 N MAIN ST",
"city": "SPRING VALLEY",
"state": "NY",
"postal_code": "109774906",
"telephone_number": "844-828-2666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA LARA",
"first_name": "SORANGE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-21",
"last_updated": "2025-01-21",
"certification_date": "2025-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "973024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Valley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.