Individual provider Active NPI

Joseph Neithardt, FNP-C

  • Family Nurse Practitioner
  • Brewster, NY
National Provider Identifier
1366287740
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F353521-01 Issued in NY
Practice address
185 Route 312
Brewster, NY 10509-2337
Phone
(845) 278-7000
NPI assigned
Jun 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F353521-01 NY Primary

Addresses

Primary practice location

185 Route 312
Brewster, NY 10509-2337

Mailing address

3 Monticello Dr Apt 201
Brewster, NY 10509-5447
Phone (845) 797-5560

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918002766 NY Practitioner - Nurse Practitioner 7214478270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

  • VNS Westchester Chha Home health agency, White Plains, NY, CCN 337146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F353521-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Oct 1, 2024 Accepting new patients
Optum Medical Care, P.C. CurrentSince Oct 1, 2024 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

185 Route 312
Brewster, NY 10509
Phone (845) 225-2700

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jneithardt142514@direct.optum.com

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.

Hospital & facility affiliations 1

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": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1366287740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MONTICELLO DR APT 201",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105095447",
            "telephone_number": "845-797-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 ROUTE 312",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105092337",
            "telephone_number": "845-278-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEITHARDT",
        "first_name": "JOSEPH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353521-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.