Individual provider Active NPI

Patricia Ann Nolan, ANP

  • Adult Health Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1902062995
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
304948 Issued in NY
Practice address
2500 Nesconset Hwy BLDG 17a
Stony Brook, NY 11790-2563
Phone
(631) 751-6262
Fax
(631) 751-6268
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2022

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 304948 NY Primary

Addresses

Primary practice location

2500 Nesconset Hwy BLDG 17a
Stony Brook, NY 11790-2563

Mailing address

2500 Nesconset Hwy BLDG 17a
Stony Brook, NY 11790-2563
Phone (631) 751-6262

Other practice location 1

5 Twig Ct
Lake Grove, NY 11755-1816
Phone (631) 981-8785

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Patricia.Nolan@SBCM.cernerdirect.com
Direct Messaging Address Patricia.nolan@sbcm.cernerdirect.com

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
I20100625000409 NY Practitioner - Nurse Practitioner 8628109212 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, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
304948NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Nov 21, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Nov 21, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

Networks

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

Interoperability endpoints

  • Direct secure messaging: patricia.nolan@sbcm.cernerdirect.com

Organizations & group practices 3

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1902062995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 17A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902563",
            "telephone_number": "631-751-6262",
            "fax_number": "631-751-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 17A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902563",
            "telephone_number": "631-751-6262",
            "fax_number": "631-751-6268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Twig Ct",
            "address_purpose": "LOCATION",
            "city": "Lake Grove",
            "state": "NY",
            "postal_code": "117551816",
            "country_code": "US",
            "telephone_number": "631-981-8785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Patricia.Nolan@SBCM.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2500 Nesconset Hwy Bldg 17A",
            "city": "Stony Brook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117902563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Patricia.nolan@sbcm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2500 Nesconset Hwy Bldg 17A",
            "city": "Stony Brook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117902563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.