Individual provider Active NPI

Elena Sapon, NP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1851182893
Registry record updated Apr 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F356378 Issued in NY
Practice address
11 Ralph PL Ste 209
Staten Island, NY 10304-4405
Phone
(929) 580-9757
Fax
(646) 349-2117
NPI assigned
May 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 356378 NY
Family Nurse Practitioner 363LF0000X F356378 NY Primary

Addresses

Primary practice location

11 Ralph PL Ste 209
Staten Island, NY 10304-4405

Mailing address

322 Sand LN
Staten Island, NY 10305-4551
Phone (929) 580-9757

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
I20250903000150 NY Practitioner - Nurse Practitioner 3577064203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Ralph PL
Suite 209
Staten Island, NY 10304-4405
Phone (646) 361-8798

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F356378NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Family Health NP PLLC CurrentSince Aug 1, 2025 Accepting new patients
Keith Ryan Jackson MD PC Dermatology PastSince Aug 1, 2025 Accepting new patients

Locations

11 Ralph Pl
Ste 209
Staten Island, NY 10304
Phone (646) 361-8798

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775952000000",
    "number": "1851182893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 SAND LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054551",
            "telephone_number": "929-580-9757",
            "fax_number": "646-349-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RALPH PL STE 209",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044405",
            "telephone_number": "929-580-9757",
            "fax_number": "646-349-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPON",
        "first_name": "ELENA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-16",
        "last_updated": "2026-04-12",
        "certification_date": "2026-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "356378",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F356378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.