Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mauricio Vergara

Individual provider Gerontology Nurse Practitioner · NPI 1831966985

Mauricio Vergara is a Nurse Practitioner in Lynbrook, New York. Qualified in 2023, 3 years ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2023
Specialties on file
2

Practice location Address checks out

67 Chestnut St
Lynbrook, NY 11563-1838
Phone: (917) 612-4401
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 311550 (NY)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 311550 (NY)

Record details

NPI number1831966985
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 8, 2023
Last updated in NPPESDecember 8, 2023
Certification dateDecember 8, 2023
Mailing address67 Chestnut St, Lynbrook, NY 11563-1838

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare