Individual provider Active NPI

Sheena Mary Sam, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1891407391
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351021 Issued in NY
Practice address
425 E 61St St FL 5
New York, NY 10065-8722
Phone
(646) 962-7378
NPI assigned
Dec 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 712307 NY
Family Nurse Practitioner 363LF0000X 351021 NY Primary

Addresses

Primary practice location

425 E 61St St FL 5
New York, NY 10065-8722

Mailing address

425 E 61St St FL 5
New York, NY 10065-8722
Phone (646) 962-7378

Other practice location 1

1839 Lenox Ave
East Meadow, NY 11554-4013
Phone (516) 300-0046

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
I20230821002091 NY Practitioner - Nurse Practitioner 7315309515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
New York, NY 10065-4870
Phone (212) 746-2323

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
712307NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Jun 28, 2023 Accepting new patients
Weill Medical College of Cornell CurrentSince Jun 28, 2023 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

525 E 68th St
#F610
New York, NY 10065
Phone (212) 746-0382

425 E 61st St
Fl 5
New York, NY 10065
Phone (646) 962-7378

425 E 61st St
New York, NY 10065
Phone (212) 752-2000

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Organizations & group practices 4

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": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1891407391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E 61ST ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658722",
            "telephone_number": "646-962-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 61ST ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658722",
            "telephone_number": "646-962-7378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1839 Lenox Ave",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115544013",
            "country_code": "US",
            "telephone_number": "516-300-0046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "SHEENA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-16",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "712307",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.