Individual provider Active NPI

Michelle L Eastman, NNP

  • Neonatal Nurse Practitioner
  • Glens Falls, NY
National Provider Identifier
1518047273
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
350207 Issued in NY
Practice address
100 Park St
Pediatric Hospitalist Program of Glens Falls Hospital
Glens Falls, NY 12801-4413
Phone
(518) 926-5925
Fax
(518) 926-5917
NPI assigned
Oct 17, 2006
Last updated
Jun 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 350207 NY Primary

Addresses

Primary practice location

100 Park St
Pediatric Hospitalist Program of Glens Falls Hospital
Glens Falls, NY 12801-4413

Mailing address

100 Park Street
Glens Falls Hospital - Credentialng
Glens Falls, NY 12801-4413
Phone (518) 926-6992

Other practice location 1

315 S Manning Blvd Unit 3563C
Albany, NY 12208-1707
Phone (518) 525-6560

Other identifiers 1

IdentifierTypeStateIssuer
03767333MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address michelle.eastman@cdirectglensfallshosp.org
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20150908002270 NY Practitioner - Nurse Practitioner 2860615960 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Glens Falls Hospital Inc. CurrentSince Jul 8, 2015 Accepting new patients
Albany Medical College CurrentSince Jun 1, 2019 Accepting new patients
Albany Medical College Nurse Practitioner Current Accepting new patients
St. Peter's Hospital of the City of Albany Nurse Practitioner CurrentSince Jun 1, 2022 Accepting new patients
Albany Medical College Nurse Practitioner CurrentSince Jun 1, 2019 Accepting new patients
St. Peter's Hospital of the City of Albany Nurse Practitioner CurrentSince Jun 1, 2022 Accepting new patients
Glens Falls Hospital Inc CurrentSince Jul 8, 2015 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Nurse Practitioner CurrentSince Jun 15, 2019 Accepting new patients
Glens Falls Hospital Inc Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

315 S Manning Blvd
Rm 3563C
Albany, NY 12208
Phone (518) 525-6560

315 S Manning Blvd
Unit 3563C
Albany, NY 12208
Phone (518) 525-6560

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

79 North St
Granville, NY 12832
Phone (518) 642-0612

Interoperability endpoints

  • Direct secure messaging: meastman788821@direct.trinity-health.org

Organizations & group practices 10

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1518047273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK STREET",
            "address_2": "GLENS FALLS HOSPITAL - CREDENTIALNG",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-6992",
            "fax_number": "518-926-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK ST",
            "address_2": "PEDIATRIC HOSPITALIST PROGRAM OF GLENS FALLS HOSPITAL",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-5925",
            "fax_number": "518-926-5917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Manning Blvd Unit 3563C",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-6560",
            "fax_number": "518-944-2534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NY",
            "license": "350207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03767333",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michelle.eastman@cdirectglensfallshosp.org",
            "affiliation": "N",
            "address_1": "100 Park St",
            "address_2": "Pediatric Hospitalist Program of Glens Falls Hospital",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd Unit 3563C",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.