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

Sandra Boucicaut, NP

Individual provider Adult Health Nurse Practitioner · NPI 1760112213

Sandra Boucicaut, NP is a Nurse Practitioner in East Patchogue, New York. Qualified in 2021, 5 years ago. Practices with New York University, a 5,884-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2022
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

285 Sills Rd Bldg 5-6
East Patchogue, NY 11772-4869
Phone: (631) 228-5802
Fax: (929) 455-9868
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 310360 (NY)

Record details

NPI number1760112213
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJune 15, 2022
Last updated in NPPESFebruary 15, 2024
Certification dateFebruary 15, 2024
Mailing address14 Wall St Fl 9, New York, NY 10005-2178

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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