Individual provider Active NPI

Noelle Mary Ziemins, FNP

  • Family Nurse Practitioner
  • Newburgh, NY
National Provider Identifier
1104206804
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339402 Issued in NY
Practice address
147 Lake St
Newburgh, NY 12550-5263
Phone
(845) 563-8000
NPI assigned
Jun 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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 F339402 NY Primary

Addresses

Primary practice location

147 Lake St
Newburgh, NY 12550-5263

Mailing address

2570 Route 9W Ste 10
Cornwall, NY 12518-1370
Phone (845) 220-3100

Other identifiers 1

IdentifierTypeStateIssuer
04677010MedicaidNY

Other names 1

  • Ms. Noelle Mary Petrone Former name

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
I20160120002337 NY Practitioner - Nurse Practitioner 3476856790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Family HealthcareGroup PAC ID 4880610393, 67 clinicians

Practice addresses (Care Compare)

147 Lake St
Newburgh, NY 12550-5263
Phone (845) 563-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339402NYMDLicensed Practical Nurse
F339402NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Family Healthcare CurrentSince Jan 28, 2017 Accepting new patients
Cornerstone Family Healthcare CurrentSince Jan 28, 2017 Accepting new patients

Locations

2570 US Highway 9W
Ste 10
Cornwall, NY 12518
Phone (845) 220-3100

127 Main St
Highland Fls, NY 10928
Phone (845) 446-4040

147 Lake St
Newburgh, NY 12550
Phone (845) 416-4325

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCECD
  • Direct secure messaging: noelle.ziemins@csfh.eclinicaldirectplus.com

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1104206804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ROUTE 9W STE 10",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181370",
            "telephone_number": "845-220-3100",
            "fax_number": "845-534-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 LAKE ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505263",
            "telephone_number": "845-563-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEMINS",
        "first_name": "NOELLE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04677010",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOELLE",
            "last_name": "PETRONE",
            "middle_name": "MARY",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.