Individual provider Active NPI

Mary Miceli, NP

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1811267354
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F301013-1 Issued in NY
Practice address
223 E 34TH St
New York, NY 10016-4852
Phone
(646) 558-0842
Fax
(646) 385-7165
NPI assigned
Dec 30, 2011
Last updated
Dec 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F301013-1 NY Primary

Addresses

Primary practice location

223 E 34TH St
New York, NY 10016-4852

Mailing address

223 E 34TH St
New York, NY 10016-4852
Phone (646) 558-0842

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
I20160701001682 NY Practitioner - Nurse Practitioner 4880991124 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
301013NYMDObstetrics & Gynecology Physician
F301013-1NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince May 9, 2016 Accepting new patients
New York University CurrentSince May 9, 2016 Accepting new patients

Locations

223 E 34th St
New York, NY 10016
Phone (212) 263-8854

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: mmiceli6783@nyumc.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1811267354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 E 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164852",
            "telephone_number": "646-558-0842",
            "fax_number": "646-385-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164852",
            "telephone_number": "646-558-0842",
            "fax_number": "646-385-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F301013-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.