Individual provider Active NPI

Donna Driscoll, PHD, CPNP

  • Pediatric Nurse Practitioner
  • Valley Stream, NY
National Provider Identifier
1992285449
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
380949-1 Issued in NY
Practice address
167 E Merrick Rd
Valley Stream, NY 11580-5925
Phone
(516) 825-3030
Fax
(516) 825-4282
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 380949-1 NY Primary

Addresses

Primary practice location

167 E Merrick Rd
Valley Stream, NY 11580-5925

Mailing address

18 Flagstone LN
Westbury, NY 11590-6531
Phone (516) 455-1405

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
I20191016001690 NY Practitioner - Nurse Practitioner 3779814140 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
380949-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Laura Ploetzke Adult Health Nurse Practitioner, PC CurrentSince Dec 1, 2024 Accepting new patients
Nassau Medical Home Visits P.C. CurrentSince Sep 10, 2019 Accepting new patients
Allied Physicians Group, PLLC PastSince Apr 3, 2018 Accepting new patients

Locations

60 Queens St
Ste 100
Syosset, NY 11791
Phone (347) 267-0904

Organizations & group practices 3

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1992285449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FLAGSTONE LN",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906531",
            "telephone_number": "516-455-1405",
            "fax_number": "516-333-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 E MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805925",
            "telephone_number": "516-825-3030",
            "fax_number": "516-825-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "DONNA",
        "credential": "PHD, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "380949-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.