Ethan Thomas Seidl, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

354565 Issued in NY

Practice address

707 E Main St
Middletown, NY 10940-2650

Phone

(845) 333-7575

NPI assigned

Feb 22, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Garnet Health Urgent Care PCGroup PAC ID 5395009765, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126
• Garnet Health Medical Center Catskills Hospital, Harris, NY, CCN 330386

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eseidl49893@direct.garnethealth.org

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.

• Garnet Health Urgent Care PC

  • Urgent Care Clinic/Center
  • Middletown, NY
  • NPI 1316446651
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catskill Regional Medical Center

  dba CRMC Physician Services

  • Family Medicine Physician
  • Monticello, NY
  • NPI 1720039563

  Hospital

  Care Compare affiliation
• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772
  Care Compare affiliation
• Garnet Health Medical Center Catskills

  • Rural Acute Care Hospital
  • Harris, NY
  • NPI 1710977012
  Care Compare affiliation

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1144814062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38 Concord Rd",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "NY",
            "postal_code": "127013210",
            "country_code": "US",
            "telephone_number": "845-333-6500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Clowes Ave",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "NY",
            "postal_code": "109241956",
            "country_code": "US",
            "telephone_number": "845-333-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEIDL",
        "first_name": "ETHAN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-22",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eseidl49893@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Urgent Care PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "707 E Main St",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109402650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Second Chance Counseling PLLC
• Bonnie V Seecharran, M.D
• Self Reflection Psychological Services, PLLC
• Robyn Sellet, LCSW
• Dhana Selvaraj, MD
• Sundararajan Selvaraj, M.D.
• Sheneka Semple

• Family Nurse Practitioner in Middletown, NY
• Providers in Middletown, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.

Verify at the official NPI Registry.