Individual provider Active NPI

Kathleen Rendich, FNP

  • Family Nurse Practitioner
  • Hudson, NY
National Provider Identifier
1558491910
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
331972 Issued in NY
Practice address
71 Prospect Ave
Suite 210
Hudson, NY 12534
Phone
(518) 828-2565
Fax
(518) 828-4055
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 331972 NY Primary

Addresses

Primary practice location

71 Prospect Ave
Suite 210
Hudson, NY 12534

Mailing address

2510 Route 44
Salt Point, NY 12578-8040
Phone (845) 677-8358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20231020000894 ME Practitioner - Nurse Practitioner 0648378778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
331972NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Sep 18, 2023 Accepting new patients
Mainehealth CurrentSince Sep 18, 2023 Accepting new patients
Eriver Neurology of New York. LLC Family PastSince Apr 1, 2007 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJIAAA
  • Direct secure messaging: krendich599518@direct.mmc.mainehealth.org

Organizations & group practices 4

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1558491910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 ROUTE 44",
            "city": "SALT POINT",
            "state": "NY",
            "postal_code": "125788040",
            "telephone_number": "845-677-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 PROSPECT AVE",
            "address_2": "SUITE 210",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "12534",
            "telephone_number": "518-828-2565",
            "fax_number": "518-828-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDICH",
        "first_name": "KATHLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "331972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, NY

Sources for this page

Verify at the official NPI Registry.