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

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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 Hospital · Port Jefferson, NY · CCN 330246

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 IDStateProvider typePAC IDDetails
I20260420002052 NY Practitioner - Nurse Practitioner 8022584762 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
355924NYMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Deer Park, NY

All providers in Deer Park, NY · Family Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.