Individual provider Active NPI

Maria Y. Dubois, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodstock, NY
National Provider Identifier
1386755650
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401094-1 Issued in NY
Practice address
15 Pine Grove St
Woodstock Psychiatric Adjunctive Services
Woodstock, NY 12498-1507
Phone
(845) 679-6678
Fax
(845) 679-0324
NPI assigned
Aug 31, 2006
Last updated
Nov 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F332596 NY
Family Nurse Practitioner 363LF0000X F332596 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401094-1 NY Primary

Addresses

Primary practice location

15 Pine Grove St
Woodstock Psychiatric Adjunctive Services
Woodstock, NY 12498-1507

Mailing address

75 Red Maple Rd
Saugerties, NY 12477-9327
Phone (914) 388-6221

Other identifiers 2

IdentifierTypeStateIssuer
00473038MedicaidNY
02226424MedicaidNY

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
I20110111000057 NY Practitioner - Nurse Practitioner 6204025034 Practice locations: Woodstock, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15 Pine Grove St
Woodstock, NY 12498-1507
Phone (845) 679-6678

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
332596NYMDObstetrics & Gynecology Physician
F332596NYMDFamily Nurse Practitioner
F401094-1NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1386755650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 RED MAPLE RD",
            "city": "SAUGERTIES",
            "state": "NY",
            "postal_code": "124779327",
            "telephone_number": "914-388-6221",
            "fax_number": "845-679-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PINE GROVE ST",
            "address_2": "WOODSTOCK PSYCHIATRIC ADJUNCTIVE SERVICES",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124981507",
            "telephone_number": "845-679-6678",
            "fax_number": "845-679-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "MARIA",
        "middle_name": "Y.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F332596",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332596",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401094-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473038",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02226424",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, NY

Sources for this page

Verify at the official NPI Registry.