Individual provider Active NPI

Eric John Meneses, LPN

  • Licensed Practical Nurse
  • East Patchogue, NY
National Provider Identifier
1962616649
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
225130 Issued in NY
Practice address
15 Victoria Cir
East Patchogue, NY 11772-4530
Phone
(631) 714-4959
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 225130 NY Primary

Addresses

Primary practice location

15 Victoria Cir
East Patchogue, NY 11772-4530

Mailing address

15 Victoria Cir
East Patchogue, NY 11772-4530
Phone (631) 714-4959

Other identifiers 1

IdentifierTypeStateIssuer
01898695MedicaidNY

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
225130NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1962616649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 VICTORIA CIR",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724530",
            "telephone_number": "631-714-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 VICTORIA CIR",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724530",
            "telephone_number": "631-714-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENESES",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "225130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01898695",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.