Individual provider Active NPI

Annmarie Gennattasio, CNNP

  • Neonatal Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1790961472
Registry record updated Jan 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
350241 Issued in NY
Practice address
26901 76TH Ave
Division of Neonatology
New Hyde Park, NY 11040-1433
Phone
(718) 470-3380
NPI assigned
Jan 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 350241 NY Primary

Addresses

Primary practice location

26901 76TH Ave
Division of Neonatology
New Hyde Park, NY 11040-1433

Mailing address

26901 76TH Ave
Division of Neonatology
New Hyde Park, NY 11040-1433
Phone (718) 470-3380

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
I20081124000320 NY Practitioner - Nurse Practitioner 0840350682 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
350241NYMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Aug 7, 2016 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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.

NPI Registry JSON

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

{
    "created_epoch": "1200182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200182400000",
    "number": "1790961472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 76TH AVE",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401433",
            "telephone_number": "718-470-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26901 76TH AVE",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401433",
            "telephone_number": "718-470-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENNATTASIO",
        "first_name": "ANNMARIE",
        "name_prefix": "Ms.",
        "credential": "CNNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-13",
        "last_updated": "2008-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NY",
            "license": "350241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.