Individual provider Active NPI

Jonathan Thomas Humphreys, RPA-C

  • Medical Physician Assistant
  • Poughkeepsie, NY
National Provider Identifier
1194017772
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
014578-1 Issued in NY
Practice address
45 Reade PL
Poughkeepsie, NY 12601-3947
Phone
(845) 721-6466
NPI assigned
May 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 014578-1 NY Primary

Addresses

Primary practice location

45 Reade PL
Poughkeepsie, NY 12601-3947

Mailing address

78 Morningside Dr
Patterson, NY 12563-2308
Phone (845) 721-6466

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
I20110627000306 NY Practitioner - Physician Assistant 9133307929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Association of New York PCGroup PAC ID 8426952813, 35 clinicians

Practice addresses (Care Compare)

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone (954) 939-5000

Hospital & facility affiliations

  • Hudson Valley Hospital Center Hospital, Cortlandt Manor, NY, CCN 330267
  • Putnam Hospital Center Hospital, Carmel, NY, CCN 330273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014578-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eos Medical Group PC Past Accepting new patients
Nuvance Health Medical Practice PC Medical Past Accepting new patients
Hudson Valley Emergency Medicine PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jth9009@direct.nyp.org

Organizations & group practices 5

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 2

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1194017772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 MORNINGSIDE DR",
            "city": "PATTERSON",
            "state": "NY",
            "postal_code": "125632308",
            "telephone_number": "845-721-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-721-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "JONATHAN",
        "middle_name": "THOMAS",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014578-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.