Individual provider Active NPI

Constance Madu, NP

  • Family Nurse Practitioner
  • East Setauket, NY
National Provider Identifier
1982932158
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343479 Issued in NY
Practice address
24 Research Way Ste 500
East Setauket, NY 11733-3470
Phone
(631) 444-6270
Fax
(631) 444-7620
NPI assigned
Nov 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 343479 NY Primary
Registered Nurse 163W00000X 619181 NY

Addresses

Primary practice location

24 Research Way Ste 500
East Setauket, NY 11733-3470

Mailing address

24 Research Way Ste 500
East Setauket, NY 11733-3470
Phone (631) 444-6270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
619181NYMDRegistered Nurse
343479NYMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ms_cmadu2@landmarkhealth-direct.org

NPI Registry JSON

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1982932158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY STE 500",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333470",
            "telephone_number": "631-444-6270",
            "fax_number": "631-444-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY STE 500",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333470",
            "telephone_number": "631-444-6270",
            "fax_number": "631-444-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADU",
        "first_name": "CONSTANCE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-30",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343479",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "619181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.