Individual provider Active NPI

Novlette Antoinette Atkinson, NP ADULT HEALTH

  • Adult Health Nurse Practitioner
  • Plainview, NY
National Provider Identifier
1851196273
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F310313-01 Issued in NY
Practice address
255 Executive Dr
Plainview, NY 11803-1718
Phone
(833) 433-2273
NPI assigned
Feb 18, 2025
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F310313-01 NY Primary

Addresses

Primary practice location

255 Executive Dr
Plainview, NY 11803-1718

Mailing address

54 Carr LN
Coram, NY 11727-4060
Phone (631) 681-6953

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
I20250719000205 NY Practitioner - Nurse Practitioner 3375059124 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F310313-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Medical of New York PLLC CurrentSince May 2, 2025 Accepting new patients

Locations

255 Executive Dr
Ste 210B
Plainview, NY 11803
Phone (516) 687-9563

10 Maple St
Prt Washingtn, NY 11050
Phone (917) 746-5942

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, 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": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1851196273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 CARR LN",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274060",
            "telephone_number": "631-681-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031718",
            "telephone_number": "833-433-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "NOVLETTE",
        "middle_name": "ANTOINETTE",
        "credential": "NP ADULT HEALTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310313-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.