Individual provider Active NPI

Nancy Denis

  • Family Nurse Practitioner
  • Malone, NY
National Provider Identifier
1811408826
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342659 Issued in NY
Practice address
133 Park Street, Alice Hyde Medical Center
Malone, NY 12953
Phone
(518) 481-2581
Fax
(518) 481-2479
NPI assigned
Oct 17, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN181282 GA
Family Nurse Practitioner 363LF0000X 342659 NY Primary
Registered Nurse 163W00000X RN181282 GA

Addresses

Primary practice location

133 Park Street, Alice Hyde Medical Center
Malone, NY 12953

Mailing address

Alice Hyde Medical Center 133 Park Street
Malone, NY 12953
Phone (678) 624-9575

Other practice location 1

3480 Preston Ridge Rd
Alpharetta, GA 30005-2028
Phone (773) 292-4800

Other practice location 2

3480 Preston Ridge Rd
Alpharetta, GA 30005-2028
Phone (773) 292-4800

Other identifiers 2

IdentifierTypeStateIssuer
RN181282OtherGASTATE LICENSE
342659OtherNYSTATE LICENSE

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
I20180419001371 NY Practitioner - Nurse Practitioner 5597028878 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN181282GAMDRegistered Nurse
342659NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Current Accepting new patients
Alice Hyde Medical Center Nurse Practitioner CurrentSince Feb 20, 2018 Accepting new patients
Medical Services of Suffolk County PC CurrentSince Apr 17, 2020 Accepting new patients

Locations

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

Interoperability endpoints

  • Direct secure messaging: ndenis465476@direct.uvmhealth.org

Organizations & group practices 3

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": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811408826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ALICE HYDE MEDICAL CENTER 133 PARK STREET",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "12953",
            "telephone_number": "678-624-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PARK STREET, ALICE HYDE MEDICAL CENTER",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "12953",
            "telephone_number": "518-481-2581",
            "fax_number": "518-481-2479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3480 Preston Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300052028",
            "country_code": "US",
            "telephone_number": "773-292-4800",
            "fax_number": "312-564-4059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3480 Preston Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300052028",
            "country_code": "US",
            "telephone_number": "773-292-4800",
            "fax_number": "312-564-4059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENIS",
        "first_name": "NANCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN181282",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342659",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN181282",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN181282",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "342659",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malone, NY

Sources for this page

Verify at the official NPI Registry.