Individual provider Active NPI

Koulako Camara, NP

  • Family Nurse Practitioner
  • Valhalla, NY
National Provider Identifier
1881202612
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345691 Issued in NY
Practice address
10 Woods Rd
Valhalla, NY 10595-1529
Phone
(914) 231-1085
NPI assigned
Jul 17, 2020
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345691 NY Primary
Family Medicine Physician 207Q00000X 345691 NY

Addresses

Primary practice location

10 Woods Rd
Valhalla, NY 10595-1529

Mailing address

15 Sherwood Dr
Poughkeepsie, NY 12603-6007
Phone (845) 803-3500

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
I20201208002799 NY Practitioner - Nurse Practitioner 5193137594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

21 Reade PL
Suite 1100
Poughkeepsie, NY 12601-3986
Phone (845) 214-1922

45 Reade PL
Poughkeepsie, NY 12601-3947

670 Stoneleigh Ave
Carmel, NY 10512-3997

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
63.01
Promoting interoperability
98
Improvement activities
40
Cost
72.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
345691NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC CurrentSince Dec 14, 2020 Accepting new patients

Locations

1351 Route 55
Ste 200
Lagrangeville, NY 12540
Phone (845) 475-9622

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

Organizations & group practices 1

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": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1881202612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SHERWOOD DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036007",
            "telephone_number": "845-803-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951529",
            "telephone_number": "914-231-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARA",
        "first_name": "KOULAKO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345691",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "345691",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.