Individual provider Active NPI

Megan Nickerson, NP

  • Family Nurse Practitioner
  • Newburgh, NY
National Provider Identifier
1275999047
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349751 Issued in NY
Practice address
1 Corwin CT Ste 202
Newburgh, NY 12550-5176
Phone
(845) 670-4844
NPI assigned
Jan 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6428 CT
Family Nurse Practitioner 363LF0000X 349751 NY Primary

Addresses

Primary practice location

1 Corwin CT Ste 202
Newburgh, NY 12550-5176

Mailing address

1 Corwin CT Ste 202
Newburgh, NY 12550-5176
Phone (860) 682-0565

Other practice location 1

1 Corwin Ct Ste 202
Newburgh, NY 12550-5176
Phone (845) 391-0338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161216000602 CT Practitioner - Nurse Practitioner 5395025902 Reassigns benefits to 1 organization
I20250703000153 NY Practitioner - Nurse Practitioner 5395025902 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

Practice addresses (Care Compare)

5177 Route 9W
Suite 2
Newburgh, NY 12550-1492
Phone (845) 670-4844

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
349751NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robinson PA, LLC CurrentSince Jun 4, 2018 Accepting new patients
Valley Dolor LLC CurrentSince Jun 1, 2025 Accepting new patients
Absolute Outcomes, LLC Past Accepting new patients

Locations

85 Barnes Rd
Ste 201
Wallingford, CT 06492
Phone (203) 626-5550

1 Corwin Ct
Ste 202
Newburgh, NY 12550
Phone (845) 391-0338

5177 Route 9W
Ste 2
Newburgh, NY 12550
Phone (845) 670-4844

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1275999047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CORWIN CT STE 202",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505176",
            "telephone_number": "860-682-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CORWIN CT STE 202",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505176",
            "telephone_number": "845-670-4844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Corwin Ct Ste 202",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125505176",
            "country_code": "US",
            "telephone_number": "845-391-0338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "MEGAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6428",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.