Individual provider Active NPI

Mary Kallmeyer, F-NP

  • Family Nurse Practitioner
  • Middletown, NY
National Provider Identifier
1245705607
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343314 Issued in NY
Practice address
111 Maltese Dr
Middletown, NY 10940-2115
Phone
(845) 342-4774
NPI assigned
Oct 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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 343314 NY Primary

Addresses

Primary practice location

111 Maltese Dr
Middletown, NY 10940-2115

Mailing address

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

Other identifiers 1

IdentifierTypeStateIssuer
343314OtherNYS LICENSE

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
I20181206002363 NY Practitioner - Nurse Practitioner 7315281003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

600 Westage Business Ctr D
Fishkill, NY 12524-2281
Phone (845) 231-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
343314NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Oct 15, 2018 Accepting new patients
Middletown Medical PC CurrentSince Oct 15, 2018 Accepting new patients
Optum Medical Care, P.C. CurrentSince Feb 1, 2021 Accepting new patients
Optum Medical Care, P.C. CurrentSince Feb 1, 2021 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

672 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 279-2000

600 Westage Business Ctr Dr
#D
Fishkill, NY 12524

111 Maltese Dr
Middletown, NY 10940

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

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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 3

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": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1245705607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402115",
            "telephone_number": "845-342-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402115",
            "telephone_number": "845-342-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLMEYER",
        "first_name": "MARY",
        "credential": "F-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "343314",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.