Individual provider Active NPI

Athena Xenakis, RN

  • Home Health Clinical Nurse Specialist
  • Suffern, NY
National Provider Identifier
1821825423
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Clinical Nurse SpecialistTaxonomy code 364SH0200X
License
894293 Issued in NY
Practice address
15 Suffern PL Ste a
Suffern, NY 10901-5566
Phone
(845) 357-4500
NPI assigned
Sep 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Clinical Nurse Specialist 364SH0200X 894293 NY Primary

Addresses

Primary practice location

15 Suffern PL Ste a
Suffern, NY 10901-5566

Mailing address

43 Summerlin CT
Wappingers Falls, NY 12590-6341
Phone (845) 420-2030

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
894293NYMDHome Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
J&D Ultracare Corp CurrentSince Sep 23, 2024 Accepting new patients

Locations

15 Suffern Pl
Ste A
Suffern, NY 10901
Phone (845) 357-4500

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": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1821825423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 SUMMERLIN CT",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125906341",
            "telephone_number": "845-420-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SUFFERN PL STE A",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015566",
            "telephone_number": "845-357-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XENAKIS",
        "first_name": "ATHENA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "NY",
            "license": "894293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.