Individual ProviderDionne AveryNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address470 Clarkson Ave Ste B, Brooklyn, NY 11203-2012(718) 270-1896(718) 270-4718PECOS EnrollmentBased on the most recent information from CMS, provider Dionne Avery is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1780068767Provider TypeIndividualFull NameAvery, DionneCredentialRNGenderFemaleSole ProprietorYesEnumeration Date7/19/2015Last Updated9/24/2019Contact InformationPractice LocationPractice Address470 Clarkson Ave Ste B, Brooklyn, NY 11203-2012Phone(718) 270-1896Fax(718) 270-2653Mailing LocationMailing Address445 Lenox Rd, Brooklyn, NY 11203-2017Phone(718) 270-4718Fax(718) 270-2653Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF340310New YorkCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense686926-1New YorkProvider IdentifiersIDDescriptionIssuerID00695941DescriptionMedicaidIssuerUnlistedNew York