Individual provider Active NPI

Mary Sweeney

  • Acute Care Nurse Practitioner
  • Poughkeepsie, NY
National Provider Identifier
1174989537
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
430857 Issued in NY
Practice address
30 Columbia St
Poughkeepsie, NY 12601-3906
Phone
(845) 231-5600
Fax
(845) 231-5489
NPI assigned
Jan 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 430857 NY
Acute Care Nurse Practitioner 363LA2100X 430857 NY Primary
Gerontology Nurse Practitioner 363LG0600X 430857 NY

Addresses

Primary practice location

30 Columbia St
Poughkeepsie, NY 12601-3906

Mailing address

110 S Bedford Rd
Caremount Medical PC
Mount Kisco, NY 10549-3446
Phone (914) 241-1050

Other identifiers 1

IdentifierTypeStateIssuer
04365702MedicaidNY

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
I20160608002251 NY Practitioner - Nurse Practitioner 8123318813 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince May 23, 2016 Accepting new patients
Optum Medical Care, P.C. CurrentSince May 23, 2016 Accepting new patients
Excel Medical PC PastSince Oct 1, 2018 Accepting new patients

Locations

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

30 Columbia St
Poughkeepsie, NY 12601
Phone (845) 483-5934

Philadelphia, PA 19195

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": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1174989537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S BEDFORD RD",
            "address_2": "CAREMOUNT MEDICAL PC",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493446",
            "telephone_number": "914-241-1050",
            "fax_number": "914-242-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 COLUMBIA ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013906",
            "telephone_number": "845-231-5600",
            "fax_number": "845-231-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "NY",
            "license": "430857",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430857",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "430857",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04365702",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.