Individual provider Active NPI

Patricia L Dunn

  • Family Nurse Practitioner
  • Mount Kisco, NY
National Provider Identifier
1417103334
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
335770 Issued in NY
Practice address
30 W Main St
Mount Kisco, NY 10549-1910
Phone
(914) 666-3272
NPI assigned
Aug 12, 2008
Last updated
Jan 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 335770 NY Primary
Family Nurse Practitioner 363LF0000X 003839 CT

Addresses

Primary practice location

30 W Main St
Mount Kisco, NY 10549-1910

Mailing address

165 Main St
Ossining, NY 10562-4702
Phone (914) 941-1263

Other identifiers 4

IdentifierTypeStateIssuer
004236130MedicaidCT
03106549MedicaidNY
003839OtherCTSTATE LICENSE
335770OtherNYSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150325001147 CT Practitioner - Nurse Practitioner 7416274774 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003839CTMDClinical Social Worker
335770NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Family CurrentSince Jan 26, 2015 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: patricia.dunn.2@16244.direct.athenahealth.com

Organizations & group practices 1

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1417103334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491910",
            "telephone_number": "914-666-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "PATRICIA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335770",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003839",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236130",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03106549",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "003839",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "335770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.