Individual provider Active NPI

Madeleine Banulski Ziegler, NP

  • Adult Health Nurse Practitioner
  • Goshen, NY
National Provider Identifier
1154874139
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
307720 Issued in NY
Practice address
30 Hatfield LN
Suite 101
Goshen, NY 10924
Phone
(845) 294-2733
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 100685 CT
Registered Nurse 163W00000X 698775 NY
Adult Health Nurse Practitioner 363LA2200X 6525 CT
Adult Health Nurse Practitioner 363LA2200X 307720 NY Primary

Addresses

Primary practice location

30 Hatfield LN
Suite 101
Goshen, NY 10924

Mailing address

30 Hatfield LN
Suite 101
Goshen, NY 10924-6766
Phone (845) 294-2733

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
I20161018000837 NY Practitioner - Nurse Practitioner 2860780202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizon Medical Group PCGroup PAC ID 6103715529, 78 clinicians

Practice addresses (Care Compare)

30 Hatfield LN
Goshen, NY 10924-6768
Phone (845) 284-2733

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100685CTMDRegistered Nurse
698775NYMDRegistered Nurse
307720NYMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Medical Group, P.C. CurrentSince Aug 8, 2016 Accepting new patients
Horizon Medical Group, P.C. CurrentSince Aug 8, 2016 Accepting new patients

Locations

21 Edward J Lempka Dr
Florida, NY 10921
Phone (845) 284-2733

2 Coates Dr
Goshen, NY 10924
Phone (845) 651-1400

30 Hatfield Ln
Ste 101
Goshen, NY 10924
Phone (845) 284-2733

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGICBA

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1154874139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HATFIELD LN",
            "address_2": "SUITE 101",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246766",
            "telephone_number": "845-294-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HATFIELD LN",
            "address_2": "SUITE 101",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-294-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEGLER",
        "first_name": "MADELEINE",
        "middle_name": "BANULSKI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "100685",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "698775",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "6525",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

Verify at the official NPI Registry.