Active NPI
Deepa Jose, NP
- Adult Health Nurse Practitioner
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 30 305733
- Practice address
- 535 East 70TH St
New York, NY 10021 - Phone
- (212) 606-1000
- NPI assigned
- Nov 7, 2011
- Last updated
- Apr 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 30 305733 | NY | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | 34 340816 | NY |
Addresses
Primary practice location
535 East 70TH St
New York, NY 10021
Mailing address
1 Rolling Ridge Rd
New City, NY 10956-6931
Phone (845) 638-0063
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10 Waldron Ave
Nyack, NY 10960-2965
Phone (845) 288-2395
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305733 | NY | MD | Licensed Practical Nurse |
| 30 305733 | NY | MD | Adult Health Nurse Practitioner |
| 34 340816 | NY | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeastern Pain Management, PC | Current | Accepting new patients | |
| Neurosurgical Associates of New Jersey, P.C. | Current | Accepting new patients |
Locations
1200 E Ridgewood Ave
Ste 200
Ridgewood, NJ 07450
Phone (201) 327-8600
118 N Bedford Rd
Ste 200
Mount Kisco, NY 10549
Phone (800) 362-6220
10 Waldron Ave
Nyack, NY 10960
Phone (845) 288-2395
160 N Midland Ave
Fl 5
Nyack, NY 10960
Phone (845) 348-2243
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Neurological Surgery Physician
- Ridgewood, NJ
- NPI 1992753594
NY
-
- Pain Medicine (Anesthesiology) Physician
- Nyack, NY
- NPI 1104872589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461024000000",
"number": "1104103076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ROLLING RIDGE RD",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109566931",
"telephone_number": "845-638-0063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 EAST 70TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10021",
"telephone_number": "212-606-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSE",
"first_name": "DEEPA",
"name_prefix": "Miss",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-07",
"last_updated": "2016-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "30 305733",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NY",
"license": "34 340816",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.