Heather Colombo, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

347558 Issued in NY

Practice address

11 Orchard St
Port Jervis, NY 12771-2027

Phone

(845) 672-3995

NPI assigned

Apr 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Little Pediatrics P.C.

  • Pediatrics Physician
  • Port Jervis, NY
  • NPI 1932611340
  Medicare reassignment NPD
• Pediatric Associates of Kingston, LLC

  • Pediatrics Physician
  • Kingston, PA
  • NPI 1831201276
  NPD (past)

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1205416658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ORCHARD ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712027",
            "telephone_number": "845-672-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ORCHARD ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712027",
            "telephone_number": "845-672-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOMBO",
        "first_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-10",
        "last_updated": "2021-12-01",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "347558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherylanne Cohen, CASAC-T
• Deborah Ann Colao, LPN
• Martin Irving Colavito, CASAC
• Jeanette Collazo, R.N.
• Anthony R Collica, PMHNP
• Community Hospitalist, PLLC
• Tamera Lee Compasso, RN-CDE
• Sarah Cooper, CASAC ADVANCED
• Bruce L Coopersmith, LCSW
• Charles J. Coppolo, LCSW

• Nurse Practitioner in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.