Individual provider Active NPI

Ann M Lepine, ANP, FNP

  • Adult Health Nurse Practitioner
  • Watertown, NY
National Provider Identifier
1447253471
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F300318 Issued in NY
Practice address
53-59 Public SQ
Ste 301
Watertown, NY 13601-2674
Phone
(315) 782-2141
Fax
(315) 782-5123
NPI assigned
May 23, 2005
Last updated
Aug 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F300318 NY Primary
Family Nurse Practitioner 363LF0000X F335553 NY

Addresses

Primary practice location

53-59 Public SQ
Ste 301
Watertown, NY 13601-2674

Mailing address

53-59 Public SQ
Ste 301
Watertown, NY 13601-2674
Phone (315) 782-2141

Other identifiers 3

IdentifierTypeStateIssuer
01147158MedicaidNY
500000222OtherNYRAILROAD MEDICARE
9680885OtherNYGHI

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
I20050315000348 NY Practitioner - Nurse Practitioner 5890740823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watertown Internists PCGroup PAC ID 1355491606, 10 clinicians

Practice addresses (Care Compare)

53 -59 Public SQ
Suite 301
Watertown, NY 13601-2674
Phone (315) 782-2141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F300318NYMDAdult Health Nurse Practitioner
F335553NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Internists PC CurrentSince May 1, 1993 Accepting new patients

Locations

53-59 Public Sq
Ste 301
Watertown, NY 13601
Phone (315) 782-2141

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1447253471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53-59 PUBLIC SQ",
            "address_2": "STE 301",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012674",
            "telephone_number": "315-782-2141",
            "fax_number": "315-782-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53-59 PUBLIC SQ",
            "address_2": "STE 301",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012674",
            "telephone_number": "315-782-2141",
            "fax_number": "315-782-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPINE",
        "first_name": "ANN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "ANP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300318",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335553",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01147158",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500000222",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9680885",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.