Individual provider Active NPI

Nancy Neiditz, LPT

  • Physical Therapist
  • Monroe, NY
National Provider Identifier
1013109982
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011154 Issued in NY
Practice address
49 Forest Rd
Monroe, NY 10950
Phone
(845) 782-3242
Fax
(845) 783-7133
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 011154 NY Primary

Addresses

Primary practice location

49 Forest Rd
Monroe, NY 10950

Mailing address

49 Forest Rd
Monroe, NY 10950
Phone (845) 782-3242

Other identifiers 1

IdentifierTypeStateIssuer
01620680MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111006000217 NY Practitioner - Physical Therapist in Private Practice 4284806746 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011154NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aizer Health , Inc. CurrentSince Oct 1, 2011 Accepting new patients
Aizer Health , Inc. CurrentSince Oct 1, 2011 Accepting new patients

Locations

49 Forest Rd
Monroe, NY 10950
Phone (845) 782-3242

48 Bakertown Rd
Monroe, NY 10950
Phone (845) 774-1464

Interoperability endpoints

  • Direct secure messaging: nancy.neiditz@echc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBCIAD/Endpoint/FBCIAD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1013109982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 FOREST RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "10950",
            "telephone_number": "845-782-3242",
            "fax_number": "845-783-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 FOREST RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "10950",
            "telephone_number": "845-782-3242",
            "fax_number": "845-783-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDITZ",
        "first_name": "NANCY",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "011154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01620680",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.