Individual provider Active NPI

Elizabeth Fitzpatrick, NP

  • Gerontology Nurse Practitioner
  • Port Jervis, NY
National Provider Identifier
1356440101
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F340646 Issued in NY
Practice address
160 E Main St
Port Jervis, NY 12771-2114
Phone
(845) 858-7000
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X F340646 NY Primary

Addresses

Primary practice location

160 E Main St
Port Jervis, NY 12771-2114

Mailing address

20 Grand St
FL 3
Warwick, NY 10990-1035
Phone (845) 987-3973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
340646NYMDPsychiatry Physician
F340646NYMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1356440101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND ST",
            "address_2": "FL 3",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-987-3973",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E MAIN ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712114",
            "telephone_number": "845-858-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jervis, NY

Sources for this page

Verify at the official NPI Registry.