Individual provider Active NPI

Fern Juster, MD

  • Pediatrics Physician
  • Hawthorne, NY
National Provider Identifier
1154322550
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
158114 Issued in NY
Practice address
19 Bradhurst Ave
Suite 2400
Hawthorne, NY 10532-2140
Phone
(914) 593-8850
Fax
(914) 593-8833
NPI assigned
Aug 9, 2005
Last updated
Jul 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 158114 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave
Suite 2400
Hawthorne, NY 10532-2140

Mailing address

19 Bradhurst Ave
Ste 2400
Hawthorne, NY 10532-2140
Phone (914) 593-8850

Other identifiers 1

IdentifierTypeStateIssuer
00957075MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000670 NY Practitioner - Pediatric Medicine 5890838411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
158114NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Children's Health Physicians, LLP Pediatrics CurrentSince Nov 17, 2009 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Nov 17, 2009 Accepting new patients

Locations

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

19 Bradhurst Ave
Ste 2400
Hawthorne, NY 10532
Phone (914) 593-8850

22 Saw Mill River Rd
Ste 2
Hawthorne, NY 10532
Phone (914) 593-1606

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1154322550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "STE 2400",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-593-8850",
            "fax_number": "914-593-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "SUITE 2400",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-593-8850",
            "fax_number": "914-593-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTER",
        "first_name": "FERN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "158114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00957075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.