Individual provider Active NPI

Michelle Marie Buontempo, MSN RN CCRN CPNP

  • Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1942759592
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383078 Issued in NY
Practice address
1305 York Ave FL 9
New York, NY 10021-5663
Phone
(212) 746-2363
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 26NJ00663600 NJ
Pediatric Nurse Practitioner 363LP0200X 383078 NY Primary

Addresses

Primary practice location

1305 York Ave FL 9
New York, NY 10021-5663

Mailing address

1305 York Ave FL 9
New York, NY 10021-5663
Phone (908) 370-7944

Other practice location 1

1 Robert Wood Johnson Pl
New Brunswick, NJ 08901-1928
Phone (908) 370-7944

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
I20201214001928 NY Practitioner - Nurse Practitioner 8820400989 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NJ00663600NJMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Aug 20, 2020 Accepting new patients
Weill Medical College of Cornell CurrentSince Aug 20, 2020 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

1305 York Ave
Fl 9
New York, NY 10021
Phone (646) 962-3376

1305 York Ave
New York, NY 10021
Phone (646) 962-2020

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

520 E 70th St
#651
New York, NY 10021
Phone (212) 746-2385

Networks

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

Interoperability endpoints

  • Direct secure messaging: mib9104@direct.nyp.org

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": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1942759592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "908-370-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "212-746-2363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Robert Wood Johnson Pl",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011928",
            "country_code": "US",
            "telephone_number": "908-370-7944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUONTEMPO",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSN RN CCRN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00663600",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.