Individual provider Active NPI

Debra Frances Sheppard, ANP

  • Adult Health Nurse Practitioner
  • Amityville, NY
National Provider Identifier
1972808509
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
302739 Issued in NY
Practice address
399 County Line Rd
Amityville, NY 11701-1705
Phone
(631) 608-5655
Fax
(631) 396-0468
NPI assigned
Jan 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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 302739 NY Primary

Addresses

Primary practice location

399 County Line Rd
Amityville, NY 11701-1705

Mailing address

399 County Line Rd
Amityville, NY 11701-1705
Phone (631) 608-5655

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
I20180212001073 NY Practitioner - Nurse Practitioner 4789992587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 10, 2017 Accepting new patients

Locations

399 County Line Rd
Amityville, NY 11701
Phone (631) 264-0222

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

27005 76th Ave
Rm 228
New Hyde Park, NY 11040
Phone (718) 470-7362

27005 76th Ave
North New Hyde Pk, NY 11040

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1972808509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 COUNTY LINE RD",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011705",
            "telephone_number": "631-608-5655",
            "fax_number": "631-396-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 COUNTY LINE RD",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011705",
            "telephone_number": "631-608-5655",
            "fax_number": "631-396-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "DEBRA",
        "middle_name": "FRANCES",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "302739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.