Individual provider Active NPI

Samantha Nazzaro, FNP

  • Family Nurse Practitioner
  • Harris, NY
National Provider Identifier
1861094468
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346744 Issued in NY
Practice address
31 Kinnebrooke Rd
Harris, NY 12742
Phone
(845) 707-8400
NPI assigned
Nov 10, 2020
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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 346744 NY Primary

Addresses

Primary practice location

31 Kinnebrooke Rd
Harris, NY 12742

Mailing address

460 Awosting Rd
Pine Bush, NY 12566-5566
Phone (845) 239-6073

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
I20210216001111 NY Practitioner - Nurse Practitioner 2163837683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
The Center for Discovery IncGroup PAC ID 1557250933, 22 clinicians

Practice addresses (Care Compare)

606 Old Route 17
Monticello, NY 12701-7013
Phone (845) 707-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Discovery Inc CurrentSince Jan 1, 2021 Accepting new patients
The Center for Discovery Inc CurrentSince Jan 1, 2021 Accepting new patients

Locations

606 Old Route 17
Monticello, NY 12701
Phone (845) 707-8400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1861094468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 AWOSTING RD",
            "city": "PINE BUSH",
            "state": "NY",
            "postal_code": "125665566",
            "telephone_number": "845-239-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 KINNEBROOKE RD",
            "city": "HARRIS",
            "state": "NY",
            "postal_code": "12742",
            "telephone_number": "845-707-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZZARO",
        "first_name": "SAMANTHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harris, NY

Sources for this page

Verify at the official NPI Registry.