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NOVA FAMILY HEALTH NP, PC
NPI 1114704285
Nurse Practitioner - Family in Wantagh, NY

Active since September 12, 2023CLIA 33D2289860 · Waiver
1400 WANTAGH AVE, WANTAGH, NY 11793(516) 308-7405(516) 308-7404 Get Directions Write a Review

NPPES record last updated: July 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 8, 2024, Jul 2, 2024 (2 updates tracked since 2024).

About Nova Family Health Np, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOVA FAMILY HEALTH NP, PC (NPI 1114704285) is a healthcare organization registered as a family in Wantagh, New York and active in the NPI registry since September 2023. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Valessa Mesidor, Owner, as its authorized official.

NPPES Registry Identity

NPI1114704285
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameNOVA FAMILY HEALTH NP, PC
Location Address1400 WANTAGH AVEWantagh, NY 11793-2257
Mailing Address32 Columbia StFarmingdale, NY 11735-2606
Phone(516) 308-7405
Fax(516) 308-7404
Organization SubpartNo
Authorized OfficialValessa MesidorOwner · (516) 587-4541
Enumeration DateSeptember 12, 2023
Last NPPES UpdateJuly 8, 20242 updates tracked since enumeration
NPPES CertifiedJuly 8, 2024
✔ NPI 1114704285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
1400 WANTAGH AVE, Wantagh, NY 11793
Open in Google Maps ↗

Other Identifiers 3

Other347927NY · State License
Medicaid07863734NY
OtherA400294812NY · Medicare

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nova Family Health Np, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Nova Family Health Np, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Valessa Mesidor
Nurse Practitioner
NPI 1972276285
1400 WANTAGH AVE
Wantagh, NY 11793
(516) 308-7405
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2289860

Nova Family Health Np PC · Wantagh, NY
Active · expires Mar 26, 2027
CLIA Number33D2289860
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 18, 2023
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorValessa Mesidor
Laboratory Phone(516) 308-7406
Laboratory LocationNova Family Health Np PC1400 Wantagh Ave, Wantagh, NY 11793
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nova Family Health Np, PC's NPI number?

The NPI number for Nova Family Health Np, PC is 1114704285. It was assigned to this organization in the NPPES registry on September 12, 2023.

Where is Nova Family Health Np, PC located?

Nova Family Health Np, PC is located at 1400 Wantagh Ave, Wantagh, NY 11793. The listed phone number is (516) 308-7405.

What is Nova Family Health Np, PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Nova Family Health Np, PC enrolled in Medicare?

Yes. Nova Family Health Np, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Nova Family Health Np, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Nova Family Health Np, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Nova Family Health Np, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2289860) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Nova Family Health Np, PC was last updated on July 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.