NPIMap

Organization Active NPI

Eden Tree Medical

  • General Practice Registered Nurse
  • Valley Cottage, NY
National Provider Identifier
1093430837
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
Legal business name
EDEN TREE MEDICAL
Practice address
107 Ridge Rd
Valley Cottage, NY 10989-2466
Phone
(845) 770-4686
NPI assigned
Oct 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Martin Sheridan, RNNPI 1598480337
Title
Vice President, Coo
Phone
(917) 693-5738

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WG0000X Primary

Addresses

Primary practice location

107 Ridge Rd
Valley Cottage, NY 10989-2466

Mailing address

107 Ridge Rd
Valley Cottage, NY 10989-2466
Phone (845) 770-4686

Other identifiers 1

IdentifierTypeStateIssuer
1598480337OtherNYNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL edentreemedical@gmail.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1093430837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 RIDGE RD",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892466",
            "telephone_number": "845-770-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 RIDGE RD",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892466",
            "telephone_number": "845-770-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN TREE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "VICE PRESIDENT, COO",
        "authorized_official_telephone_number": "917-693-5738",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1598480337",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "edentreemedical@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "107 Ridge Rd",
            "city": "Valley Cottage",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109892466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Valley Cottage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.