Individual provider Active NPI

Maria Leah Cervantes, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1982810412
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F303376 Issued in NY
Practice address
1 Hollow Lane Suite 110
New Hyde Park, NY 11042-1215
Phone
(516) 365-6666
Fax
(516) 365-2183
NPI assigned
May 14, 2007
Last updated
Mar 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X F303376 NY
Adult Health Nurse Practitioner 363LA2200X F303376 NY Primary
Primary Care Nurse Practitioner 363LP2300X F303376 NY

Addresses

Primary practice location

1 Hollow Lane Suite 110
New Hyde Park, NY 11042-1215

Mailing address

29 Peter LN
Plainview, NY 11803-5631

Other names 1

  • Leah Cervantes Professional name

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
I20160125001765 NY Order and Referring Only - Nurse Practitioner 7012210040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F303376NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paul B Lang MD PC Single Specialty PastSince Oct 6, 1995 Accepting new patients
Susan E.Panes, D.O. P.C. Single Specialty Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1982810412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 PETER LN",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118035631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOLLOW LANE SUITE 110",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421215",
            "telephone_number": "516-365-6666",
            "fax_number": "516-365-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "MARIA LEAH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F303376",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303376",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F303376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "CERVANTES",
            "credential": "NURSE PRACTITIONER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.