Individual provider Active NPI

Colleen Perrotta

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1801658000
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
310503 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-6942
NPI assigned
Jan 24, 2024
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 310503 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

329 Barrack Hill Rd
Ridgefield, CT 06877-3004
Phone (914) 393-2753

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
I20240326003872 NY Practitioner - Nurse Practitioner 3375980378 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

530 E 74TH St
New York, NY 10021-3402
Phone (212) 639-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310503NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hematology Lymphoma Group CurrentSince Mar 11, 2024 Accepting new patients
Mskcc Clinical Practice Plan CurrentSince Mar 11, 2024 Accepting new patients
Mskcc Clinical Practice Plan CurrentSince Mar 11, 2024 Accepting new patients
Memorial Hematology Lymphoma Group Current Accepting new patients

Locations

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
New York, NY 10017

Networks

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

Interoperability endpoints

  • Direct secure messaging: cperrotta41332@mskcc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1801658000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 BARRACK HILL RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068773004",
            "telephone_number": "914-393-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERROTTA",
        "first_name": "COLLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "310503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.