Individual provider Active NPI

Jessica Derochie, FNP

  • Family Nurse Practitioner
  • Norwich, NY
National Provider Identifier
1215547245
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345940 Issued in NY
Practice address
45 Hale St
Norwich, NY 13815-2038
Phone
(607) 336-1479
NPI assigned
Aug 4, 2020
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345940 NY Primary

Addresses

Primary practice location

45 Hale St
Norwich, NY 13815-2038

Mailing address

45 Hale St
Norwich, NY 13815-2038

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
I20201021000979 NY Practitioner - Nurse Practitioner 0345660957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Karen R Banks Lindner DO PLLCGroup PAC ID 3971526104, 2 clinicians

Practice addresses (Care Compare)

45 -47 Hale St
Norwich, NY 13815-2038

45 Hale St
Suite 47
Norwich, NY 13815-2038

4547 Hale St
Norwich, NY 13815-2038
Phone (607) 336-1749

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
345940NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Karen R. Banks-Lindner, DO, PLLC CurrentSince Nov 1, 2020 Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1215547245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 HALE ST",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138152038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 HALE ST",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138152038",
            "telephone_number": "607-336-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROCHIE",
        "first_name": "JESSICA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, NY

Sources for this page

Verify at the official NPI Registry.