Individual provider Active NPI

Tina Lesevic, FNP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1861784191
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336743 Issued in NY
Practice address
44 Myrtle Ave
Staten Island, NY 10310-2057
Phone
(917) 572-4870
NPI assigned
May 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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 336743 NY Primary

Addresses

Primary practice location

44 Myrtle Ave
Staten Island, NY 10310-2057

Mailing address

44 Myrtle Ave
Staten Island, NY 10310-2057
Phone (917) 572-4870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110610000019 NJ Order and Referring Only - Nurse Practitioner 2062699564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1861784191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MYRTLE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102057",
            "telephone_number": "917-572-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 MYRTLE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102057",
            "telephone_number": "917-572-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESEVIC",
        "first_name": "TINA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.