Individual provider Active NPI

Donnet Andrea Riley, FNP

  • Family Nurse Practitioner
  • Bronxville, NY
National Provider Identifier
1821621301
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345155 Issued in NY
Practice address
781 Palmer Rd Apt 3a
Bronxville, NY 10708-3309
Phone
(772) 475-1348
NPI assigned
Feb 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345155 NY Primary

Addresses

Primary practice location

781 Palmer Rd Apt 3a
Bronxville, NY 10708-3309

Mailing address

781 Palmer Rd Apt 3a
Bronxville, NY 10708-3309
Phone (772) 475-1348

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
I20201006000999 NY Practitioner - Nurse Practitioner 6608295944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

1210 Webster Ave
Bronx, NY 10456-4208
Phone (646) 612-7747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
345155NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Divinity Medical Services PLLC CurrentSince Jun 19, 2024 Accepting new patients

Locations

1210 Webster Ave
Bronx, NY 10456
Phone (646) 612-7747

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

Organizations & group practices 1

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": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1821621301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 PALMER RD APT 3A",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083309",
            "telephone_number": "772-475-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 PALMER RD APT 3A",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083309",
            "telephone_number": "772-475-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "DONNET",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronxville, NY

Sources for this page

Verify at the official NPI Registry.