Individual provider Active NPI

Amy Michelle Wasserman, M.D.

  • Rheumatology Physician
  • Hawthorne, NY
National Provider Identifier
1003056268
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
278234 Issued in NY
Practice address
19 Bradhurst Ave
Suite 3070N
Hawthorne, NY 10532-2140
Phone
(914) 372-7887
Fax
(914) 372-7884
NPI assigned
Mar 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 239748 MA
Rheumatology Physician 207RR0500X A97716 CA
Rheumatology Physician 207RR0500X 278234 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave
Suite 3070N
Hawthorne, NY 10532-2140

Mailing address

19 Bradhurst Ave
Suite 3070N
Hawthorne, NY 10532-2140
Phone (914) 372-7887

Other identifiers 1

IdentifierTypeStateIssuer
110082710AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150323001587 NY Practitioner - Rheumatology 2961555230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530

19 Bradhurst Ave
Hawthorne, NY 10532-2140

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A97716CAMDRheumatology Physician
278234NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Mar 1, 2015 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Mar 1, 2015 Accepting new patients
Westchester Medical Center Past Accepting new patients

Locations

19 Bradhurst Ave
Ste 3060N
Hawthorne, NY 10532
Phone (914) 372-7887

19 Bradhurst Ave
Ste 3070N
Hawthorne, NY 10532
Phone (914) 372-7887

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1003056268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "SUITE 3070N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-372-7887",
            "fax_number": "914-372-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "SUITE 3070N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-372-7887",
            "fax_number": "914-372-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-01",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "239748",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A97716",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "278234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110082710A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.