Individual provider Active NPI

Elizabeth Anne Blyman Archer, NP

  • Acute Care Nurse Practitioner
  • Garden City, NY
National Provider Identifier
1861944340
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
432063 Issued in NY
Practice address
975 Stewart Ave
Garden City, NY 11530-4816
Phone
(516) 222-8600
NPI assigned
Oct 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 201608839NP-PP OR
Acute Care Nurse Practitioner 363LA2100X 432063 NY Primary

Addresses

Primary practice location

975 Stewart Ave
Garden City, NY 11530-4816

Mailing address

975 Stewart Ave
Garden City, NY 11530-4816
Phone (516) 222-8600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address earcher481483@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170127001930 OR Practitioner - Nurse Practitioner 9133401045 Reassigns benefits to 1 organization
I20211117001490 NY Practitioner - Nurse Practitioner 9133401045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

975 Stewart Ave
Garden City, NY 11530-4816
Phone (516) 222-8602

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Dec 6, 2021 Accepting new patients
Legacy Clinics LLC CurrentSince Feb 20, 2017 Accepting new patients
New York University CurrentSince Dec 6, 2021 Accepting new patients
Legacy Clinics LLC CurrentSince Feb 20, 2017 Accepting new patients
Nyumc Radiology Associates Past Accepting new patients

Locations

975 Stewart Ave
Garden City, NY 11530
Phone (516) 222-8600

530 1st Ave
Ste 9N
New York, NY 10016
Phone (212) 263-7080

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

501 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4488

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1040 NW 22nd Ave
Ste 660
Portland, OR 97210
Phone (503) 692-0405

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 5

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 7

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": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1861944340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304816",
            "telephone_number": "516-222-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304816",
            "telephone_number": "516-222-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE BLYMAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201608839NP-PP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "432063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "earcher481483@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "975 Stewart Ave",
            "city": "Garden City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115304816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.