Rachel Anglade
Individual provider Active NPI Family Nurse Practitioner · Deer Park, NY
NPI 1972399012 · NPPES record last updated Apr 16, 2025
Key facts
- NPI
- 1972399012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 355924 (NY)
- Practice address
- 503 Nicolls Rd
Deer Park, NY 11729-3211 - Phone
- (646) 379-2825
- NPI assigned
- Apr 16, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
145 Old Country Rd
Melville, NY 11747-2011
PO
Philadelphia, PA 19195-0001
Hospital & facility affiliations
- St Charles Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260420002052 | NY | Practitioner - Nurse Practitioner | 8022584762 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 355924 | NY | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 355924 | NY | Yes |
Addresses
Primary practice location
503 Nicolls Rd
Deer Park, NY 11729-3211
Mailing address
503 Nicolls Rd
Deer Park, NY 11729-3211
Phone (646) 379-2825
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All providers in Deer Park, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.