Individual provider Active NPI

Esther Max, FNP-BC

  • Family Nurse Practitioner
  • Fresh Meadows, NY
National Provider Identifier
1811647290
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355963 Issued in NY
Practice address
7119 162ND St # CF-C
Fresh Meadows, NY 11365-4444
Phone
(718) 475-0500
NPI assigned
Mar 28, 2022
Reactivated
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 83785801 NY
Family Nurse Practitioner 363LF0000X 355963 NY Primary

Addresses

Primary practice location

7119 162ND St # CF-C
Fresh Meadows, NY 11365-4444

Mailing address

7119 162ND St # CF-C
Fresh Meadows, NY 11365-4444
Phone (718) 475-0500

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
I20250701002289 NY Order and Referring Only - Nurse Practitioner 7416460613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
83785801NYMDRegistered Nurse
355963NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1811647290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7119 162ND ST # CF-C",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654444",
            "telephone_number": "718-475-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7119 162ND ST # CF-C",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654444",
            "telephone_number": "718-475-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAX",
        "first_name": "ESTHER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "deactivation_date": "2025-05-01",
        "reactivation_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "83785801",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.