Individual provider Active NPI

Mary Ellen Schaefer, ANP-C

  • Adult Health Nurse Practitioner
  • Southampton, NY
National Provider Identifier
1558649244
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
305771 Issued in NY
Practice address
4 Millstone Dr
Southampton, NY 11968-5613
Phone
(631) 374-0534
NPI assigned
Jul 28, 2011
Last updated
Jul 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 305771 NY Primary

Addresses

Primary practice location

4 Millstone Dr
Southampton, NY 11968-5613

Mailing address

4 Millstone Dr
Southampton, NY 11968-5613
Phone (631) 374-0534

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
I20130628000054 NY Practitioner - Nurse Practitioner 8527208354 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.72 of 100Reported as apm
Quality
72.97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Northeast, LLC CurrentSince Sep 9, 2024 Accepting new patients
Hospitalist Healthcare Services PLLC CurrentSince Dec 11, 2013 Accepting new patients
NV Pacs 2 LLC CurrentSince Jun 15, 2021 Accepting new patients
New York General Medical Services PC CurrentSince Dec 1, 2017 Accepting new patients
Hospitalist Healthcare Services PLLC CurrentSince Dec 11, 2013 Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3530 Wayne Ave
Bronx, NY 10467
Phone (718) 655-1700

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

4241 201st St
Flushing, NY 11361
Phone (516) 599-5688

2090 Albany Post Rd
Montrose, NY 10548

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

17850 Linden Blvd
Rochdale Village, NY 11434
Phone (718) 990-0300

1 Elsie St
Rome, NY 13440
Phone (315) 336-4435

101 Elm St
Sayville, NY 11782
Phone (631) 244-2400

100 Lake Rd
Vly Cottage, NY 10989
Phone (845) 268-6813

3 Barker Ave
Fl 4
White Plains, NY 10601
Phone (914) 949-7900

Organizations & group practices 6

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1558649244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MILLSTONE DR",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685613",
            "telephone_number": "631-374-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MILLSTONE DR",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685613",
            "telephone_number": "631-374-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

Verify at the official NPI Registry.