Individual provider Active NPI

Mirlyne Richardson-Oriental

  • Adult Health Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1811140684
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
306460 Issued in NY
Practice address
16 Hudson Ave
Valley Stream, NY 11580-4026
Phone
(516) 849-6816
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 238787 NY
Adult Health Nurse Practitioner 363LA2200X 306460 NY Primary

Addresses

Primary practice location

16 Hudson Ave
Valley Stream, NY 11580-4026

Mailing address

23218 Merrick Blvd
Laurelton, NY 11413-2115
Phone (718) 528-3432

Other identifiers 1

IdentifierTypeStateIssuer
010556898MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
238787NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Verdun Home Health Care Inc Past Accepting new patients
Verdun Home Health Care Inc Past Accepting new patients

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": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1811140684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23218 MERRICK BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132115",
            "telephone_number": "718-528-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HUDSON AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804026",
            "telephone_number": "516-849-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON-ORIENTAL",
        "first_name": "MIRLYNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "238787",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010556898",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.