Individual provider Active NPI

Kathleen Nicpon, NP

  • Family Nurse Practitioner
  • West Haverstraw, NY
National Provider Identifier
1467664797
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F332957 Issued in NY
Practice address
51 N Route 9W
West Haverstraw, NY 10993-1127
Phone
(845) 786-4109
Fax
(845) 786-4526
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F332957 NY Primary

Addresses

Primary practice location

51 N Route 9W
West Haverstraw, NY 10993-1127

Mailing address

50-51 RT 9W
West Haverstraw, NY 10993-1195
Phone (845) 786-4109

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
I20080409000448 NY Practitioner - Nurse Practitioner 4981781358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
State of New York Comptrollers OfficeGroup PAC ID 0840101770, 171 clinicians

Practice addresses (Care Compare)

Route 9W
West Haverstraw, NY 10993-1195
Phone (845) 786-4097

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
73.89
Promoting interoperability
89
Improvement activities
40
Cost
75.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F332957NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office CurrentSince Jan 1, 2010 Accepting new patients
State of New York CurrentSince Jan 1, 2010 Accepting new patients
State of New York Comptrollers Office Current Accepting new patients

Locations

51 N Route 9W
West Haverstraw, NY 10993
Phone (845) 786-4060

Organizations & group practices 3

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1467664797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50-51 RT 9W",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931195",
            "telephone_number": "845-786-4109",
            "fax_number": "845-786-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N ROUTE 9W",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931127",
            "telephone_number": "845-786-4109",
            "fax_number": "845-786-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICPON",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haverstraw, NY

Sources for this page

Verify at the official NPI Registry.