Individual provider Active NPI

Mary Ellen Sennert, GNP

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1952487704
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F340186 Issued in NY
Practice address
1 Penn PLZ
Suite 725
New York, NY 10119-0002
Phone
(347) 963-8973
Fax
(877) 351-0599
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F340186 NY Primary

Addresses

Primary practice location

1 Penn PLZ
Suite 725
New York, NY 10119-0002

Mailing address

49 Blue Spruce Road
Levittown, NY 11756-1500
Phone (347) 963-8973

Other identifiers 1

IdentifierTypeStateIssuer
02289747MedicaidNY

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
I20060421000354 NY Practitioner - Nurse Practitioner 8628047131 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F340186NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MJHS Medical Associates CurrentSince Nov 5, 2020 Accepting new patients

Locations

55 Water St
Fl 46
New York, NY 10041
Phone (212) 440-1943

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1952487704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BLUE SPRUCE ROAD",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561500",
            "telephone_number": "347-963-8973",
            "fax_number": "877-351-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PENN PLZ",
            "address_2": "SUITE 725",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190002",
            "telephone_number": "347-963-8973",
            "fax_number": "877-351-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENNERT",
        "first_name": "MARY ELLEN",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F340186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02289747",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.