Individual provider Active NPI

Tresa Smitha Prince, ADULT NP

  • Adult Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1801295373
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
306628 Issued in NY
Practice address
85 W Burnside Ave
Bronx, NY 10453-4015
Phone
(718) 716-4400
NPI assigned
Aug 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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 306628 NY Primary

Addresses

Primary practice location

85 W Burnside Ave
Bronx, NY 10453-4015

Mailing address

85 W Burnside Avenue
Bronx, NY 10543
Phone (718) 716-4400

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
I20150924002316 NY Practitioner - Nurse Practitioner 2466760400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

85 W Burnside Ave
Bronx, NY 10453-4015
Phone (718) 483-1270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306628NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Heights Health Center, Inc. CurrentSince Aug 11, 2015 Accepting new patients
Morris Heights Health Center, Inc. CurrentSince Aug 11, 2015 Accepting new patients

Locations

85 W Burnside Ave
Bronx, NY 10453
Phone (718) 483-1270

Networks

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

Interoperability endpoints

  • Direct secure messaging: tresa.prince.p1@direct.mhhc.nextgenshare.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": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1801295373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W BURNSIDE AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10543",
            "telephone_number": "718-716-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534015",
            "telephone_number": "718-716-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "TRESA",
        "middle_name": "SMITHA",
        "name_prefix": "Mrs.",
        "credential": "ADULT NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.