Individual provider Active NPI

Lisa Vanderhoff, RN

  • Registered Nurse
  • Brewster, NY
National Provider Identifier
1518277581
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
874298 Issued in NY
Practice address
111 Clock Tower Commons
Brewster, NY 10509-4055
Phone
(845) 279-5187
NPI assigned
Oct 8, 2010
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 874298 NY Primary

Addresses

Primary practice location

111 Clock Tower Commons
Brewster, NY 10509-4055

Mailing address

390 Austin Rd
Mahopac, NY 10541-2700
Phone (845) 628-4574

Other names 1

  • Lisa Holstein Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
874298NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1518277581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 AUSTIN RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412700",
            "telephone_number": "845-628-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CLOCK TOWER COMMONS",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094055",
            "telephone_number": "845-279-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHOFF",
        "first_name": "LISA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "874298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HOLSTEIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brewster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.