Individual provider Active NPI

Michelle Leanne Pellegrino, RN

  • Registered Nurse
  • New York, NY
National Provider Identifier
1871016006
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
716778-1 Issued in NY
Practice address
795 Columbus Ave Apt 14B
New York, NY 10025-5962
Phone
(203) 313-0336
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 716778-1 NY Primary

Addresses

Primary practice location

795 Columbus Ave Apt 14B
New York, NY 10025-5962

Mailing address

795 Columbus Ave Apt 14B
New York, NY 10025-5962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
716778-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1871016006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 COLUMBUS AVE APT 14B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 COLUMBUS AVE APT 14B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255962",
            "telephone_number": "203-313-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINO",
        "first_name": "MICHELLE",
        "middle_name": "LEANNE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "716778-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.