Individual provider Active NPI

Medina Vernon, M.D.

  • Internal Medicine Physician
  • Poughkeepsie, NY
National Provider Identifier
1346647724
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
289877 Issued in NY
Practice address
159 Barnegat Rd
Poughkeepsie, NY 12601-5401
Phone
(845) 592-4915
Fax
(845) 592-4914
NPI assigned
Dec 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 289877 NY Primary

Addresses

Primary practice location

159 Barnegat Rd
Poughkeepsie, NY 12601-5401

Mailing address

159 Barnegat Rd
Poughkeepsie, NY 12601-5401
Phone (845) 592-4915

Other practice location 1

760 Broadway
Brooklyn, NY 11206-5317
Phone (718) 963-8000

Other identifiers 1

IdentifierTypeStateIssuer
03874935MedicaidNY

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
I20170901002139 NY Practitioner - Internal Medicine 3173896784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

45 Reade PL
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
63.01
Promoting interoperability
98
Improvement activities
40
Cost
72.3

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC Internal Medicine CurrentSince Dec 7, 2019 Accepting new patients
Vassar Brothers Hospital Past Accepting new patients

Locations

111 Clock Tower Cmns
Brewster, NY 10509
Phone (845) 592-4915

111 Clock Tower Cmns
#22
Brewster, NY 10509

313 S William St
Newburgh, NY 12550
Phone (845) 569-9662

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

159 Barnegat Rd
Poughkeepsie, NY 12601
Phone (845) 454-1942

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 2

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": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1346647724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 BARNEGAT RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015401",
            "telephone_number": "845-592-4915",
            "fax_number": "845-592-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BARNEGAT RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015401",
            "telephone_number": "845-592-4915",
            "fax_number": "845-592-4914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERNON",
        "first_name": "MEDINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "289877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03874935",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.