Individual provider Active NPI

Vernard C Pelage

  • Acute Care Nurse Practitioner
  • Rockville Centre, NY
National Provider Identifier
1962202549
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F433246-01 Issued in NY
Practice address
1332 Langdon Blvd
Rockville Centre, NY 11570-3540
Phone
(347) 351-6201
NPI assigned
Mar 14, 2025
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F433246-01 NY Primary

Addresses

Primary practice location

1332 Langdon Blvd
Rockville Centre, NY 11570-3540

Mailing address

1332 Langdon Blvd
Rockville Centre, NY 11570-3540
Phone (347) 351-6201

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
I20250512000723 NY Practitioner - Nurse Practitioner 5092232280 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Anesthesiology GroupGroup PAC ID 8729977129, 298 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F433246-01NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Feb 1, 2026 Accepting new patients
New York University CurrentSince Feb 1, 2026 Accepting new patients
Memorial Anesthesiology Group CurrentSince May 12, 2025 Accepting new patients

Locations

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

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

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, 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": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1962202549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 LANGDON BLVD",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703540",
            "telephone_number": "347-351-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 LANGDON BLVD",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703540",
            "telephone_number": "347-351-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELAGE",
        "first_name": "VERNARD",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F433246-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.