Individual provider Active NPI

Benny K Mathew

  • Family Nurse Practitioner
  • New City, NY
National Provider Identifier
1558110726
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F351816 Issued in NY
Practice address
53 New Hempstead Rd
New City, NY 10956-3627
Phone
(845) 638-5615
NPI assigned
May 18, 2024
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F351816 NY Primary
Emergency Registered Nurse 163WE0003X 633719 NY

Addresses

Primary practice location

53 New Hempstead Rd
New City, NY 10956-3627

Mailing address

695 Little Britain Rd
New Windsor, NY 12553-6152
Phone (347) 409-3019

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
I20241001003304 NY Practitioner - Nurse Practitioner 0446781439 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
633719NYMDEmergency Registered Nurse
F351816NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC CurrentSince Nov 11, 2024 Accepting new patients
Health Quest Medical Practice, PC CurrentSince Nov 11, 2024 Accepting new patients

Locations

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

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, 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": "1715990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1558110726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 LITTLE BRITAIN RD",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125536152",
            "telephone_number": "347-409-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 NEW HEMPSTEAD RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109563627",
            "telephone_number": "845-638-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "BENNY",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F351816",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NY",
            "license": "633719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.