Individual provider Active NPI

Mirlyne Andre, NP

  • Primary Care Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1902306509
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F354158-01 Issued in NY
Practice address
1587 E 49TH St
Brooklyn, NY 11234-3126
Phone
(929) 302-1856
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 744373 NY
Primary Care Nurse Practitioner 363LP2300X F354158-01 NY Primary

Addresses

Primary practice location

1587 E 49TH St
Brooklyn, NY 11234-3126

Mailing address

1587 E 49TH St
Brooklyn, NY 11234-3126
Phone (929) 302-1856

Other names 1

  • Mirlyne Andre Professional name

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
I20241206001124 NY Practitioner - Nurse Practitioner 6002342664 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
744373NYMDRegistered Nurse
F354158-01NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Special Medical PC CurrentSince Jan 11, 2026 Accepting new patients
Elnunu Medical PC CurrentSince Nov 1, 2024 Accepting new patients

Locations

2311 Coney Island Ave
Brooklyn, NY 11223
Phone (718) 676-2436

596 Pennsylvania Ave
Brooklyn, NY 11207
Phone (347) 442-5847

Networks

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

Organizations & group practices 2

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": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1902306509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1587 E 49TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343126",
            "telephone_number": "929-302-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1587 E 49TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343126",
            "telephone_number": "929-302-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRE",
        "first_name": "MIRLYNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "744373",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F354158-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRLYNE",
            "last_name": "ANDRE",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.