Individual provider Active NPI

Beth A Saubermann, MSN, ANP

  • Adult Health Nurse Practitioner
  • Kingston, NY
National Provider Identifier
1508001066
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305043 Issued in NY
Practice address
360 Washington Ave
Kingston, NY 12401
Phone
(845) 338-7140
Fax
(845) 338-7141
NPI assigned
Dec 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305043 NY Primary

Addresses

Primary practice location

360 Washington Ave
Kingston, NY 12401

Mailing address

360 Washington Ave
Kingston, NY 12401
Phone (845) 338-7140

Other identifiers 1

IdentifierTypeStateIssuer
03395333MedicaidNY

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
I20111128000003 NY Practitioner - Nurse Practitioner 4688848815 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
F305043NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Avenue Medicine Community Care CurrentSince Jul 1, 2023 Accepting new patients
Medical Associates of the Hudson Valley CurrentSince Feb 1, 2017 Accepting new patients
Hurley Ave Family Med PLLC CurrentSince Jun 7, 2022 Accepting new patients
Nydh Physician Practice Past Accepting new patients
Hurley Avenue Family Medicine Past Accepting new patients

Locations

146 Jefferson Hts
Catskill, NY 12414
Phone (518) 943-3415

211 Hurley Ave
Kingston, NY 12401
Phone (845) 339-2804

360 Washington Ave
Kingston, NY 12401
Phone (845) 338-7140

3190 Route 9W
Saugerties, NY 12477
Phone (845) 246-2836

Organizations & group practices 5

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": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1508001066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUBERMANN",
        "first_name": "BETH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MSN, ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03395333",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.