Individual provider Active NPI

Deirdre McKibbin-Vaughan, PA

  • Medical Physician Assistant
  • Poughkeepsie, NY
National Provider Identifier
1235240771
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
004393 Issued in NY
Practice address
1 Columbia St
Suite 200
Poughkeepsie, NY 12601-3923
Phone
(845) 473-1188
Fax
(845) 473-0896
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 004393 NY Primary

Addresses

Primary practice location

1 Columbia St
Suite 200
Poughkeepsie, NY 12601-3923

Mailing address

1 Columbia St
Suite 200
Poughkeepsie, NY 12601-3923
Phone (845) 473-1188

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
I20040709000848 NY Practitioner - Physician Assistant 6406834142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Valley Cardiovascular Practice PCGroup PAC ID 0244467181, 67 clinicians

Practice addresses (Care Compare)

1 Columbia St
Poughkeepsie, NY 12601-3924

33 Grand St
Suite 55
Kingston, NY 12401-3933
Phone (845) 339-8700

6511 Spring Brook Ave
Suite 1006
Rhinebeck, NY 12572-3709
Phone (845) 473-1188

Hospital & facility affiliations

  • Archcare at Home Home health agency, Valhalla, NY, CCN 337140
  • Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049
  • Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023

Merit-based Incentive Payment System (MIPS)

Final score
78.69 of 100Reported as group
Quality
54.12
Promoting interoperability
98
Improvement activities
40
Cost
76.5

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Hudson Family Health Institute Past Accepting new patients

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235240771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COLUMBIA ST",
            "address_2": "SUITE 200",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013923",
            "telephone_number": "845-473-1188",
            "fax_number": "845-473-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLUMBIA ST",
            "address_2": "SUITE 200",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013923",
            "telephone_number": "845-473-1188",
            "fax_number": "845-473-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIBBIN-VAUGHAN",
        "first_name": "DEIRDRE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "004393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.