Individual provider Active NPI

Jeffrey Alan Vernon, DO

  • Student in an Organized Health Care Education/Training Program
  • Seneca Falls, NY
National Provider Identifier
1376786004
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
34.015473 Issued in OH
Practice address
41 Spring St
Seneca Falls, NY 13148-2021
Phone
(917) 725-0762
Fax
(905) 963-1689
NPI assigned
Apr 10, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 252671 NY
Student in an Organized Health Care Education/Training Program 390200000X 34.015473 OH Primary

Addresses

Primary practice location

41 Spring St
Seneca Falls, NY 13148-2021

Mailing address

1 W 4TH St Apt 1406
Cincinnati, OH 45202-3856
Phone (917) 725-0762

Other practice location 1

1 W 4th St Apt 1406
Cincinnati, OH 45202-3856
Phone (917) 725-0762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250422000364 OH Order and Referring Only - NeurologyPractitioner - NeurologyPractitioner - PsychiatryPractitioner - Neuropsychiatry 1052447109

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey a Vernon, DO, PLLC Psychiatry CurrentSince Dec 24, 2023 Accepting new patients
Westchester Faculty Psychological Associates PC Past Accepting new patients

Locations

140 Route 303
Vly Cottage, NY 10989
Phone (845) 267-2172

Interoperability endpoints

  • Direct secure messaging: jvernon667174@nychhc.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1376786004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W 4TH ST APT 1406",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452023856",
            "telephone_number": "917-725-0762",
            "fax_number": "905-963-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 SPRING ST",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131482021",
            "telephone_number": "917-725-0762",
            "fax_number": "905-963-1689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 W 4th St Apt 1406",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452023856",
            "country_code": "US",
            "telephone_number": "917-725-0762",
            "fax_number": "905-963-1689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERNON",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-10",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "252671",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "34.015473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca Falls, NY

Sources for this page

Verify at the official NPI Registry.