Individual provider Active NPI

Patricia Moran, NP

  • Adult Health Nurse Practitioner
  • Commack, NY
National Provider Identifier
1962543827
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
303649 Issued in NY
Practice address
283 Commack Rd
Suite 200
Commack, NY 11725-6021
Phone
(631) 499-2226
Fax
(631) 499-1419
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 303649 NY Primary

Addresses

Primary practice location

283 Commack Rd
Suite 200
Commack, NY 11725-6021

Mailing address

283 Commack Rd
Suite 200
Commack, NY 11725-6021
Phone (631) 499-2226

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
I20041129000365 NY Practitioner - Nurse Practitioner 9638134901 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
303649NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Huntington Hospital Association Past Accepting new patients
Dix Hills Medical Association PC Past Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients
St. Francis Hospital Past Accepting new patients

Networks

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

Organizations & group practices 5

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1962543827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 COMMACK RD",
            "address_2": "SUITE 200",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117256021",
            "telephone_number": "631-499-2226",
            "fax_number": "631-499-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 COMMACK RD",
            "address_2": "SUITE 200",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117256021",
            "telephone_number": "631-499-2226",
            "fax_number": "631-499-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "PATRICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.