Individual provider Active NPI

Fern Baudo, RN, NP BC APRN

  • Adult Health Nurse Practitioner
  • Williston Park, NY
National Provider Identifier
1154544500
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F303237 Issued in NY
Practice address
108 Capitol Ave
Williston Park, NY 11596-1621
Phone
(646) 235-4633
NPI assigned
Apr 11, 2007
Last updated
Sep 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F303237 NY Primary
Hospice Registered Nurse 163WH1000X 476531 NY

Addresses

Primary practice location

108 Capitol Ave
Williston Park, NY 11596-1621

Mailing address

283 E 4TH St
Apt #5a
New York, NY 10009-7533
Phone (646) 235-4633

Other identifiers 1

IdentifierTypeStateIssuer
F303237OtherNYNP LICENSE NUMBER

Other names 1

  • Ms. Fern Wasserman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
476531NYMDHospice Registered Nurse
303237NYMDLicensed Practical Nurse
F303237NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fern Baudo Adult Health Nurse Practitioner PC Adult Health CurrentSince Dec 1, 2012 Accepting new patients
Northern Valley Vascular Associates Past Accepting new patients
New York Legal Nurse Consultants Inc Adult Health PastSince Dec 1, 2012 Accepting new patients

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, 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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1154544500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 E 4TH ST",
            "address_2": "APT #5A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097533",
            "telephone_number": "646-235-4633",
            "fax_number": "646-964-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 CAPITOL AVE",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115961621",
            "telephone_number": "646-235-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUDO",
        "first_name": "FERN",
        "name_prefix": "Mrs.",
        "credential": "RN, NP BC APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303237",
            "primary": true
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "NY",
            "license": "476531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "F303237",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FERN",
            "last_name": "WASSERMAN",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Williston Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.