Individual provider Active NPI

Janet Mary Tiberia, PNP

  • Pediatric Nurse Practitioner
  • Albany, NY
National Provider Identifier
1679512396
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F380750 Issued in NY
Practice address
1092 Madison Ave
Pediatrics
Albany, NY 12208-2248
Phone
(518) 525-2445
Fax
(518) 475-7069
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F380750 NY Primary

Addresses

Primary practice location

1092 Madison Ave
Pediatrics
Albany, NY 12208-2248

Mailing address

2 Bayberry Cir
Poestenkill, NY 12140-2309

Other identifiers 1

IdentifierTypeStateIssuer
01878459MedicaidNY

Other names 1

  • Janet Mary Carmody Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1679512396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BAYBERRY CIR",
            "city": "POESTENKILL",
            "state": "NY",
            "postal_code": "121402309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 MADISON AVE",
            "address_2": "PEDIATRICS",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082248",
            "telephone_number": "518-525-2445",
            "fax_number": "518-475-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBERIA",
        "first_name": "JANET",
        "middle_name": "MARY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F380750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01878459",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "CARMODY",
            "middle_name": "MARY",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.