Individual provider Active NPI

Megan Fendt, CNM RD CDCES

  • Advanced Practice Midwife
  • East Setauket, NY
National Provider Identifier
1386962348
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
6 Technology Dr
East Setauket, NY 11733-4079
Phone
(631) 444-4686
NPI assigned
May 13, 2010
Last updated
Dec 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X NY Primary

Addresses

Primary practice location

6 Technology Dr
East Setauket, NY 11733-4079

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-4686

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201005002676 NY Practitioner - Certified Nurse Midwife (CNM) 1658551940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
002012NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
University Associates in Obstetrics & Gynecology, University Faculty P CurrentSince Sep 1, 2020 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

6 Technology Dr
Setauket, NY 11733
Phone (631) 444-2790

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: megan.fendt.1@22846.direct.athenahealth.com
  • Direct secure messaging: mfendt859674@nychhc.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1386962348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TECHNOLOGY DR",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334079",
            "telephone_number": "631-444-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDT",
        "first_name": "MEGAN",
        "credential": "CNM RD CDCES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.