Individual provider Active NPI

Sinu Punnoose, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1861690505
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334391-1 Issued in NY
Practice address
1Penn Plaza, Suite 725
Optum
New York, NY 10119-3140
Phone
(646) 398-2325
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2014

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 F334391-1 NY Primary

Addresses

Primary practice location

1Penn Plaza, Suite 725
Optum
New York, NY 10119-3140

Mailing address

1Penn Plaza, Suite 725
Optum
New York, NY 10119
Phone (646) 398-2325

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
I20211101002955 NY Practitioner - Nurse Practitioner 2365673704 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
334391NYMDPsychiatry Physician
F334391-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dialog Healthcare, LLC CurrentSince May 13, 2023 Accepting new patients
Optum Care Services Company Family PastSince Jan 1, 2014 Accepting new patients

Locations

50 Chestnut Ridge Rd
Ste 130
Montvale, NJ 07645
Phone (845) 213-3134

1235 Pelham Pkwy N
Bronx, NY 10469
Phone (718) 231-4300

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.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1861690505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1PENN PLAZA, SUITE 725",
            "address_2": "OPTUM",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10119",
            "telephone_number": "646-398-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1PENN PLAZA, SUITE 725",
            "address_2": "OPTUM",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101193140",
            "telephone_number": "646-398-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNNOOSE",
        "first_name": "SINU",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334391-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.