Individual provider Active NPI

Tina Wasilko

  • Licensed Practical Nurse
  • Manorville, NY
National Provider Identifier
1942510854
Registry record updated Jan 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
302730-1 Issued in NY
Practice address
1 Sherry CT
Manorville, NY 11949-3307
Phone
(631) 801-2789
NPI assigned
Oct 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 302730-1 NY Primary

Addresses

Primary practice location

1 Sherry CT
Manorville, NY 11949-3307

Mailing address

1 Sherry CT
Manorville, NY 11949
Phone (631) 830-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
302730-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768089600000",
    "number": "1942510854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHERRY CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "11949",
            "telephone_number": "631-830-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHERRY CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119493307",
            "telephone_number": "631-801-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASILKO",
        "first_name": "TINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2026-01-11",
        "certification_date": "2026-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "302730-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manorville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.