Active NPI
Esopus Medical, PC
- Family Medicine Physician
- Rifton, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 52862
- Legal business name
- ESOPUS MEDICAL, PC
- Practice address
- 105 Woodcrest Dr
Rifton, NY 12471-7200 - Phone
- (845) 658-7763
- NPI assigned
- Feb 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Monika R.a. Mommsen, MD
- Title
- President
- Phone
- (845) 658-7763
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 52862 | NY | Primary |
Addresses
Primary practice location
105 Woodcrest Dr
Rifton, NY 12471-7200
Mailing address
10 Hellbrook LN
Ulster Park, NY 12487-5209
Phone (845) 658-7763
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02533053 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, TN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040818001017 | NY | Part B Supplier - Clinic/Group Practice | 1254304074 |
Receives reassigned benefits from 15 practitioners Practice locations: Chester, NY; Elka Park, NY; Esopus, NY; Rifton, NY; Ulster Park, NY; Walden, NY |
| O20230406002919 | TN | Part B Supplier - Clinic/Group Practice | 1254304074 |
Receives reassigned benefits from 1 practitioner Practice locations: Madisonville, TN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0719608 | Esopus Medical PC | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryLocations
359 Gibson Hill Rd
Chester, NY 10918
Phone (845) 572-3400
2255 Platte Clove Rd
Elka Park, NY 12427
Phone (518) 589-5103
100 Maple Ridge Dr
Ulster Park, NY 12487
Phone (845) 372-4619
120 Maple Ridge Dr
Ulster Park, NY 12487
151 Bowne Dr
Walden, NY 12586
Phone (845) 481-7014
301 Hiwassee Community Dr
Madisonville, TN 37354
Phone (423) 436-7730
Practitioners & affiliated clinicians
Practitioners 26
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Ulster Park, NY
- NPI 1447228002
Family Medicine, NY
-
- Family Medicine Physician
- Esopus, NY
- NPI 1841266475
Family Medicine, NY
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1665360000000",
"number": "1295701787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 HELLBROOK LN",
"city": "ULSTER PARK",
"state": "NY",
"postal_code": "124875209",
"telephone_number": "845-658-7763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 WOODCREST DR",
"city": "RIFTON",
"state": "NY",
"postal_code": "124717200",
"telephone_number": "845-658-7763"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ESOPUS MEDICAL, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-24",
"last_updated": "2022-10-10",
"certification_date": "2022-10-10",
"status": "A",
"authorized_official_last_name": "MOMMSEN",
"authorized_official_first_name": "MONIKA",
"authorized_official_middle_name": "R.A.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "845-658-7763",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NY",
"license": "52862",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02533053",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rifton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.