Michele Amundson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F336293-1 Issued in NY

Practice address

161 E Main St
Suite 301
Port Jervis, NY 12771-2113

Phone

(845) 856-3812

Fax

(845) 856-3820

NPI assigned

May 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Excelcare Medical Associates, PA

  • Internal Medicine Physician
  • Teaneck, NJ
  • NPI 1992736300
  Medicare reassignment Care Compare group NPD
• Recoverhealth Medical Services, PLLC

  • Surgery Physician
  • Suffern, NY
  • NPI 1184859381
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1578882981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND ST",
            "address_2": "3RD FLOOR",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-987-3972",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 E MAIN ST",
            "address_2": "SUITE 301",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712113",
            "telephone_number": "845-856-3812",
            "fax_number": "845-856-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336293-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia Lourdes Abadilla
• Moinuddin Ahmed, MD
• Ann M Akers, MDIV, LP
• Alitons Managed Care Pharmacy Inc
• Gabrielle Andzel
• Holly Aschoff, LMSW
• Rebecca L Aschoff, RN
• Althea Atkinson, RN
• Kristin E Banse, PT

• Family Nurse Practitioner in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.