Individual provider Active NPI

Richard Cloney, NP

  • Adult Health Nurse Practitioner
  • Center Moriches, NY
National Provider Identifier
1891269619
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308829 Issued in NY
Practice address
625 Montauk Hwy
Center Moriches, NY 11934-2200
Phone
(631) 878-7134
NPI assigned
Jan 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 308829 NY Primary

Addresses

Primary practice location

625 Montauk Hwy
Center Moriches, NY 11934-2200

Mailing address

625 Montauk Hwy
Center Moriches, NY 11934-2200
Phone (631) 878-7134

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
I20221121000582 NY Practitioner - Nurse Practitioner 3072981224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bay Medical Care P.C.Group PAC ID 3678620275, 2 clinicians

Practice addresses (Care Compare)

625 Main St
Center Moriches, NY 11934-2200
Phone (631) 878-7134

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Medical Care P.C. CurrentSince Oct 18, 2022 Accepting new patients

Locations

625 Montauk Hwy
Ctr Moriches, NY 11934
Phone (631) 878-7134

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1891269619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MONTAUK HWY",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119342200",
            "telephone_number": "631-878-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MONTAUK HWY",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119342200",
            "telephone_number": "631-878-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLONEY",
        "first_name": "RICHARD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Moriches, NY

Sources for this page

Verify at the official NPI Registry.