Individual provider Active NPI

Patricia Mazzetti-Rudy, F.N.P.

  • Family Nurse Practitioner
  • Poughkeepsie, NY
National Provider Identifier
1073857454
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337448 Issued in NY
Practice address
375 Hooker Ave
Poughkeepsie, NY 12603-3627
Phone
(845) 527-9288
NPI assigned
Nov 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 337448 NY Primary

Addresses

Primary practice location

375 Hooker Ave
Poughkeepsie, NY 12603-3627

Mailing address

211 Hurley Ave
Kingston, NY 12401-2400
Phone (845) 339-2804

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160622002037 NY Practitioner - Nurse Practitioner 9931490943 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
337448NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Jul 13, 2019 Accepting new patients
Statline Medical PC CurrentSince Jun 1, 2021 Accepting new patients
Advantagecare Physicians PC CurrentSince Jul 13, 2019 Accepting new patients
Doctors United, Inc CurrentSince May 1, 2019 Accepting new patients
Hurley Avenue Family Medicine Past Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

215 E 95th St
New York, NY 10128
Phone (212) 423-3111

451 Broad St
Salamanca, NY 14779
Phone (716) 945-1800

176 Grand St
White Plains, NY 10601
Phone (914) 328-6080

174 Grand St
White Plains, NY 10601
Phone (718) 220-8293

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 5

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": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1073857454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012400",
            "telephone_number": "845-339-2804",
            "fax_number": "845-338-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 HOOKER AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033627",
            "telephone_number": "845-527-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZETTI-RUDY",
        "first_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.