Individual provider Active NPI

Patricia Marie Mahoney, C.N.M.

  • Advanced Practice Midwife
  • Port Chester, NY
National Provider Identifier
1104867761
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F000295 Issued in NY
Practice address
5 Grace Church St
Port Chester, NY 10573-4911
Phone
(914) 937-8899
Fax
(914) 937-7932
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F000295 NY Primary

Addresses

Primary practice location

5 Grace Church St
Port Chester, NY 10573-4911

Mailing address

165 Main St
Ossining, NY 10562-4702
Phone (914) 941-1263

Other identifiers 1

IdentifierTypeStateIssuer
01677265MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051128000688 NY Practitioner - Certified Nurse Midwife (CNM) 6305866021 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000295NYMDAcupuncturist
F000295NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Family Medical Center, Inc. CurrentSince Dec 9, 2022 Accepting new patients
Open Door Family Medical Center Inc Current Accepting new patients
Phelps Memorial Hospital Association Past Accepting new patients

Locations

165 Main St
Ossining, NY 10562
Phone (914) 941-1263

5 Grace Church St
Port Chester, NY 10573
Phone (914) 937-8899

Networks

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

Interoperability endpoints

  • Direct secure messaging: pmahoney56091@northwell.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EAJCAA
  • Direct secure messaging: patricia.mahoney@odfmc.eclinicaldirectplus.com

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1104867761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRACE CHURCH ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734911",
            "telephone_number": "914-937-8899",
            "fax_number": "914-937-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F000295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01677265",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.