Individual provider Active NPI

John Mazzei, FNP

  • Family Nurse Practitioner
  • Poughkeepsie, NY
National Provider Identifier
1265801377
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339830 Issued in NY
Practice address
74 West Cedar St
Poughkeepsie, NY 12601
Phone
(845) 454-6174
Fax
(845) 454-5371
NPI assigned
Sep 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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 F339830 NY Primary

Addresses

Primary practice location

74 West Cedar St
Poughkeepsie, NY 12601

Mailing address

74 West Cedar St
Poughkeepsie, NY 12601
Phone (845) 454-6174

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
I20151021002112 NY Practitioner - Nurse Practitioner 4486963048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

243 N Rd
Suite 304
Poughkeepsie, NY 12601-1173
Phone (845) 471-9410

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F339830NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of the Hudson Valley P.C. CurrentSince Oct 5, 2020 Accepting new patients
Damian Family Care Centers, Inc. CurrentSince Oct 2, 2018 Accepting new patients
Damian Family Care Centers, Inc. CurrentSince Oct 2, 2018 Accepting new patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince Oct 5, 2020 Accepting new patients

Locations

8956 162nd St
#3
Jamaica, NY 11432
Phone (718) 297-8000

13750 Jamaica Ave
Jamaica, NY 11435
Phone (718) 298-5100

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

243 North Rd
Ste 101B
Poughkeepsie, NY 12601

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

Interoperability endpoints

  • Direct secure messaging: jmazzei@premiermedicalhv.medentdirect.com

Organizations & group practices 4

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1265801377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 WEST CEDAR ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "845-454-6174",
            "fax_number": "845-454-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 WEST CEDAR ST",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "845-454-6174",
            "fax_number": "845-454-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZEI",
        "first_name": "JOHN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-18",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.