SELF EMPLOYED (NPI# 1033582291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033582291 |
| Entity Type | Organization |
| Organization Name | SELF EMPLOYED |
| Practice Address |
74 Mill Dr Mastic Beach NY 11951-1403 |
| Mailing Address |
67 Radburn Dr Farmingville NY 11738-1046 |
| Practice Telephone | 6315998372 |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2015-11-09 |
| Authorized Official Name | MS. KAITLYN SYMANCYK (REGISTERED NURSE) |
| Authorized Official Telephone | 6312358057 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 705976-1 | NY | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942616214 | Self Employed | Home Health Aide | 7634 Kelvinway Dr, Worthington, OH 43085-5304 | 2014-07-08 |
| 1639208085 | Self Employed | Registered Nurse | 442 Calle Flandes, San Juan, PR 00923-1712 | 2007-03-03 |
| 1205224904 | Self Employed | Speech-Language Pathologist | 11608 W 101st Ter, Overland Park, KS 66214-2710 | 2015-01-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SELF EMPLOYED | 10 St Patrick Pl, Ballston Lake, NY 12019-1840 |
| System for Award Management (SAM) Entities | SELF EMPLOYED COMMERCIAL FISHING | 2043 Jakes Little Fireweed Ln, Homer, AK 99603-9319 |
| Washington State Corporations | SELF EMPLOYED LLC | 406 Bangor Ave, Lubbock, TX 79416-4323 |
| Colorado Business Entities | Self Employed Single Dad, LLC | 8641 E. Dry Creek Rd., Unit 514, Centennial, CO 80112 |
| Street Address |
74 MILL DR |
| City | MASTIC BEACH |
| State | NY |
| Zip Code | 11951-1403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437271525 | Jessica B Conlon | Licensed Practical Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2007-04-06 |
| 1043758717 | Jessica Fischer | Licensed Practical Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2017-02-02 |
| 1740632496 | Carissa Ellis | Registered Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2016-07-06 |
| 1750730370 | Orlandria Palmer | Licensed Practical Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2016-06-03 |
| 1720486194 | Nicoletta Colabella | Licensed Practical Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2014-12-16 |
| 1912308107 | Melissa Johnston | Registered Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2014-09-08 |
| 1376960229 | Deesse Jean Baptiste | Licensed Practical Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2014-03-27 |
| 1861829566 | Stephanie Marie Giampetruzzi | Licensed Practical Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2013-09-26 |
| 1194151886 | Chinaedu S Asia | Licensed Practical Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2013-09-25 |
| 1780023366 | Andreza Martinta | Registered Nurse | 74 Mill Dr, Mastic Beach, NY 11951-1403 | 2013-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689173577 | Diana Perreco | Licensed Practical Nurse | 47 Montauk Dr, Mastic Beach, NY 11951 | 2018-02-06 |
| 1366832321 | Taylor Viggers | Specialist/Technologist | Tangier Smith Elementary School, 336 Blanco Drive, Mastic Beach, NY 11951 | 2015-01-29 |
| 1497159735 | Fabiola Reid | Counselor | 834 A East Main Street, Center Moriches, NY 11951 | 2014-10-15 |
| 1548674906 | Jacqueline D Searing | Local Education Agency (LEA) | 240 Mastic Beach Road, Mastic Beach, NY 11951 | 2014-06-13 |
| 1275890659 | Shaquana Marie Williams | Nurse's Aide | 143 Huntington Dr, Mastic Beach, NY 11951 | 2012-04-23 |
| 1790912889 | Mariann Cali | Developmental Therapist | 215 Laurelton Drive, Mastic Beach, NY 11951 | 2009-06-16 |
| 1225495518 | Steven Zore | Acupuncturist | 279 Madison St, Mastic Beach, NY 11951-1003 | 2016-01-19 |
| 1386907566 | Raven Guy | Licensed Practical Nurse | 530 Mastic Rd, Mastic Beach, NY 11951-1012 | 2012-06-21 |
| 1790384410 | Gina Siracusano | Specialist/Technologist | 630 Mastic Rd Ste 4, Mastic Beach, NY 11951-1020 | 2020-10-23 |
| 1134429939 | Natalie Beth Gieser | Speech-Language Pathologist | 338 Blanco Dr, Mastic Beach, NY 11951-1021 | 2010-10-26 |
| Find all providers in zip 11951 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730701343 | Diamond Medical Employment Agency Inc | Skilled Nursing Facility | 21873 Hempstead Ave, Queens Village, NY 11429-2103 | 2020-05-18 |
| 1427670884 | Morris Park Rehabilitation and Nursing Center LLC | Skilled Nursing Facility | 1235 Pelham Parkway North, Bronx, NY 10469 | 2020-05-08 |
| 1659936334 | Nelson Tannis | Skilled Nursing Facility | 165 Broadway, New York, NY 10006-1404 | 2019-05-07 |
| 1295390029 | Westgate Operations Associates LLC | Skilled Nursing Facility | 525 Beahan Rd, Rochester, NY 14624-3403 | 2019-05-07 |
| 1952883423 | Roscoe Regional Healthcare LLC | Skilled Nursing Facility | 420 Rockland Rd, Roscoe, NY 12776-6450 | 2018-08-31 |
| 1164904769 | Renaissance Healthcare Group, LLC | Skilled Nursing Facility | 4975 Albany Post Rd, Staatsburg, NY 12580-6032 | 2018-08-30 |
| 1477049807 | Itkin Occupational Therapy PC | Skilled Nursing Facility | 134 Mackenzie Street, Brooklyn, NY 11235 | 2018-07-09 |
| 1699280826 | 239 Legris Avenue Operations LLC | Skilled Nursing Facility | 3118 Quentin Rd, Brooklyn, NY 11234-4235 | 2017-12-11 |
| 1376058578 | Yonkers Gardens, LLC | Skilled Nursing Facility | 115 S Broadway, Yonkers, NY 10701-4006 | 2017-12-10 |
| 1104355536 | Massapequa Center LLC | Skilled Nursing Facility | 101 Louden Ave., Amityville, NY 11701 | 2017-06-08 |
| Find all providers with the same taxonomy | ||||
| City | MASTIC BEACH |
| Zip Code | 11951 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.