Individual provider Active NPI

Amne Intissar, AGACNP

  • Acute Care Nurse Practitioner
  • Poughkeepsie, NY
National Provider Identifier
1538846258
Registry record updated Jul 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F432647-01 Issued in NY
Practice address
241 North Rd
Poughkeepsie, NY 12601-1154
Phone
(845) 483-5000
NPI assigned
Jul 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209027601 IL
Nurse Practitioner 363L00000X 2023018697 MO
Acute Care Nurse Practitioner 363LA2100X F432647-01 NY Primary

Addresses

Primary practice location

241 North Rd
Poughkeepsie, NY 12601-1154

Mailing address

1064 Oxford Hill Rd
O Fallon, IL 62269-6825
Phone (206) 579-7657

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
I20230905003694 NY Practitioner - Nurse Practitioner 3274996400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209027601ILMDNurse Practitioner
2023018697MOMDNurse Practitioner
F432647-01NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Sep 1, 2023 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Sep 1, 2023 Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1538846258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 OXFORD HILL RD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696825",
            "telephone_number": "206-579-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 NORTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011154",
            "telephone_number": "845-483-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTISSAR",
        "first_name": "AMNE",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027601",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023018697",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F432647-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.