Jacqueline M Kelderhouse, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

331520 Issued in NY

Practice address

1425 Walton Ave
Montefiore School Clinic
Bronx, NY 10452-6901

Phone

(718) 681-8088

Fax

(718) 537-6015

NPI assigned

Oct 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1376628495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 WALTON AVE",
            "address_2": "MONTEFIORE SCHOOL CLINIC",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104526901",
            "telephone_number": "718-681-8088",
            "fax_number": "718-537-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 WALTON AVE",
            "address_2": "MONTEFIORE SCHOOL CLINIC",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104526901",
            "telephone_number": "718-681-8088",
            "fax_number": "718-537-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELDERHOUSE",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "331520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold D Keiser, MD
• Keisha a Ballentine-Cargill NP in Family Health, P.C.
• Shannon Keisling, M.D.
• Hamed Bushery Keita, NURSING
• Saran Keita
• Dorothy Ann Kelen, RN
• Lawrence Kelleher, DO
• Eric Nelson Keller, D.C.
• Marla J Keller, MD
• Peter Karl Keller, M.D.

• Family Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.