Individual provider Active NPI

Marisa G. Flanagan, FNP-BC

  • Nurse Practitioner
  • Kingston, NY
National Provider Identifier
1598702227
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F330823 Issued in NY
Practice address
117 Marys Ave
Ste 201
Kingston, NY 12401-5849
Phone
(845) 331-8146
Fax
(845) 331-3314
NPI assigned
Jun 1, 2006
Last updated
Apr 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F330823 NY Primary
Registered Nurse 163W00000X 427027 NY

Addresses

Primary practice location

117 Marys Ave
Ste 201
Kingston, NY 12401-5849

Mailing address

117 Marys Ave
Ste 201
Kingston, NY 12401-5849
Phone (845) 331-8146

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
I20040818000299 NY Practitioner - Nurse Practitioner 0042283970 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
427027NYMDRegistered Nurse
F330823NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hal N. Buch, MD PC CurrentSince Aug 7, 2016 Accepting new patients
Mid-Hudson Family Health Institute Past Accepting new patients
Facial Plastic, Reconstructive & Laser Surgery, PLLC Past Accepting new patients

Locations

117 Marys Ave
Ste 201
Kingston, NY 12401
Phone (845) 331-8146

6464 Montgomery St
Rhinebeck, NY 12572
Phone (845) 331-8146

Interoperability endpoints

  • Direct secure messaging: mflanagan@halnbuchmd.medentdirect.com

Organizations & group practices 3

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1598702227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MARYS AVE",
            "address_2": "STE 201",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015849",
            "telephone_number": "845-331-8146",
            "fax_number": "845-331-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MARYS AVE",
            "address_2": "STE 201",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015849",
            "telephone_number": "845-331-8146",
            "fax_number": "845-331-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANAGAN",
        "first_name": "MARISA",
        "middle_name": "G.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F330823",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "427027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.