NPIMap

Individual provider Active NPI

Justine L Waldman, MD

  • Emergency Medicine Physician
  • Ithaca, NY
National Provider Identifier
1659471845
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
225677 Issued in NY
Practice address
101 Dates Dr
Ithaca, NY 14850-1342
Phone
(607) 274-4150
Fax
(607) 274-4132
NPI assigned
Sep 25, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 225677 NY Primary

Addresses

Primary practice location

101 Dates Dr
Ithaca, NY 14850-1342

Mailing address

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4150

Other identifiers 4

IdentifierTypeStateIssuer
00220092OtherABEM
225677OtherNYSTATE LICENSE
A70878OtherCASTATE LICENSE
02298626MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080523000241 NY Practitioner - Emergency Medicine 3971672437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reach Medical PLLCGroup PAC ID 8123381993, 10 clinicians

Practice addresses (Care Compare)

1001 W Seneca St
Ithaca, NY 14850-3342
Phone (607) 273-7000

402 N Cayuga St
Ithaca, NY 14850-4291
Phone (607) 273-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
225677NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Reach Project Inc CurrentSince Feb 1, 2018 Accepting new patients
Reach Medical PLLC CurrentSince Feb 26, 2018 Accepting new patients
Emergency Physician Services of New York, P.C. Emergency Medicine Past Accepting new patients
Cayuga Medical Center at Ithaca Past Accepting new patients
New York Em-I Medical Services PC Emergency Medicine Past Accepting new patients
New York Em-I Medical Services PC Emergency Medicine Past Accepting new patients
Chemung Medical Services PC Emergency Medicine Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients
Emergency Medicine Physicians of Ulster County,PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Cortland County, PLLC Emergency Medicine Past Accepting new patients
New York Em-I Medical Services PC Emergency Medicine Past Accepting new patients
Cayuga Medical Center at Ithaca Past Accepting new patients

Locations

1001 W Seneca St
Ithaca, NY 14850
Phone (607) 273-7000

402 N Cayuga St
Ithaca, NY 14850
Phone (607) 273-5551

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17251/brand/1/csg/1/fhir/r4
  • Direct secure messaging: justine.waldman.1@17251.direct.athenahealth.com

Organizations & group practices 12

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1659471845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4150",
            "fax_number": "607-274-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4150",
            "fax_number": "607-274-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "JUSTINE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "225677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABEM",
            "identifier": "00220092",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "225677",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A70878",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02298626",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.