Individual provider Active NPI

Heidi H Vandeusen, NPP

  • Nurse Practitioner
  • Gloversville, NY
National Provider Identifier
1275601155
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
400586 Issued in NY
Practice address
241 Steele Ave
Gloversville, NY 12078
Phone
(518) 725-4414
Fax
(518) 725-4414
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 400586 NY Primary

Addresses

Primary practice location

241 Steele Ave
Gloversville, NY 12078

Mailing address

2219 St Hwy 67
Johnstown, NY 12095
Phone (518) 762-5035

Other identifiers 1

IdentifierTypeStateIssuer
345316OtherNYMVP

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
I20140226001197 NY Practitioner - Nurse Practitioner 5395975957 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nysarc Inc Fulton County ChapterGroup PAC ID 5890717979, 27 clinicians
New Dimensions in Living IncGroup PAC ID 8921089905, 5 clinicians

Practice addresses (Care Compare)

127 E State St
Gloversville, NY 12078-1204
Phone (518) 736-3937

40 Wall St
Amsterdam, NY 12010-4309
Phone (518) 843-2575

405 County Hwy 114
Saint Johnsville, NY 13452-2307
Phone (518) 736-3937

43 Harrison St
Gloversville, NY 12078-4708
Phone (518) 736-3937

465 N Perry St
Johnstown, NY 12095-1014
Phone (518) 736-3937

83 Briggs St
Johnstown, NY 12095-1504
Phone (518) 736-3937

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Dimensions in Living Inc CurrentSince May 1, 2020 Accepting new patients
Nysarc Inc Fulton County Chapter CurrentSince Jan 1, 2013 Accepting new patients

Locations

40 Wall St
Amsterdam, NY 12010
Phone (518) 843-2575

127 E State St
Gloversville, NY 12078
Phone (518) 773-7931

465 N Perry St
Johnstown, NY 12095
Phone (518) 736-3937

Interoperability endpoints

  • Direct secure messaging: vandeuh@lexclinic.medentdirect.com

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 9

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275601155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 ST HWY 67",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "12095",
            "telephone_number": "518-762-5035",
            "fax_number": "518-725-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 STEELE AVE",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "12078",
            "telephone_number": "518-725-4414",
            "fax_number": "518-725-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEUSEN",
        "first_name": "HEIDI",
        "middle_name": "H",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "400586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "345316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloversville, NY

Sources for this page

Verify at the official NPI Registry.