Individual provider Active NPI

Alla Nusonovna Adler, NURSE PRACTITIONER/N

  • Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1972076107
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F308820-1 Issued in NY
Practice address
76Winchester Ave
Staten Island, NY 10312
Phone
(718) 605-2767
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amboy Medical Practice PC 171 clinicians

Practice addresses (Care Compare)

1366 Victory Blvd
Suite a
Staten Island, NY 10301-3948
Phone (718) 816-4949

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20190710002949 NY Practitioner - Nurse Practitioner 0143555359 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F308820-1NYMDNurse Practitioner

Practice roles (2 of 5)

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince May 25, 2019 Accepting new patients
Amboy Medical Practice PC CurrentSince May 25, 2019 Accepting new patients

Locations

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

1366 Victory Blvd
Ste A
Staten Island, NY 10301
Phone (718) 727-1366

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

Networks

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

Interoperability endpoints

  • Direct secure messaging: alla.adler.1@19656.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F308820-1 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

76Winchester Ave
Staten Island, NY 10312

Mailing address

76Winchester Ave
Staten Island, NY 10312

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 10, 2019.

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1972076107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76WINCHESTER AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76WINCHESTER AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10312",
            "telephone_number": "718-605-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADLER",
        "first_name": "ALLA",
        "middle_name": "NUSONOVNA",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER/N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F308820-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.