Martin Sheridan, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

46107101 Issued in NY

Practice address

107 Ridge Rd
Valley Cottage, NY 10989-2466

Phone

(845) 770-4686

NPI assigned

Oct 4, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Eden Tree Medical

  • General Practice Registered Nurse
  • Valley Cottage, NY
  • NPI 1093430837
  NPD Authorized official

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1598480337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 RIDGE RD",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892466",
            "telephone_number": "845-770-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 RIDGE RD",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892466",
            "telephone_number": "845-770-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "MARTIN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "46107101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "46107101",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "edentreemedical@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "107 Ridge Rd",
            "city": "Valley Cottage",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109892466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maryse Sannon
• Alyssa Schmidt
• Krupa Selvaraj
• Michelle Servedio, MS/ED
• Shannon L. Bender, M.S., CCC-SLP, LLC
• Satish Ramanna Shetty, MS
• Janice Denise Shields
• Noreen Shimkus
• Yubin Shin, LMHC-LP
• Sujung Shon, RN

• General Practice Registered Nurse in Valley Cottage, NY
• Providers in Valley Cottage, NY by specialty
• General Practice Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.