Individual provider Active NPI

Stephen Hermele, MD

  • Psychiatry Physician
  • Kingston, NY
National Provider Identifier
1306896113
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
106332 Issued in NY
Practice address
368 Broadway Ste 402
Kingston, NY 12401-5159
Phone
(845) 334-2824
Fax
(845) 339-4527
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 106332 NY Primary

Addresses

Primary practice location

368 Broadway Ste 402
Kingston, NY 12401-5159

Mailing address

PO Box 2364
Kingston, NY 12402-2364
Phone (845) 338-8850

Other identifiers 1

IdentifierTypeStateIssuer
7195058OtherNYAETNA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080212000221 NY Practitioner - Psychiatry 1850358649 Practice locations: Kingston, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York Medical College, 1968
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

51 Hurley Ave
Suite 102
Kingston, NY 12401-3747
Phone (845) 331-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
106332NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Hudson Family Health Institute Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1306896113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2364",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124022364",
            "telephone_number": "845-338-8850",
            "fax_number": "845-339-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 BROADWAY STE 402",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015159",
            "telephone_number": "845-334-2824",
            "fax_number": "845-339-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMELE",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "106332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7195058",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.