Individual provider Active NPI

Caitlin C Griffin, NP

  • Pediatric Nurse Practitioner
  • Ithaca, NY
National Provider Identifier
1700431376
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F383048-01 Issued in NY
Practice address
10 Graham Rd W
Ithaca, NY 14850-1055
Phone
(607) 257-5958
Fax
(607) 266-7341
NPI assigned
Aug 9, 2019
Last updated
Aug 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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 F383048-01 NY Primary

Addresses

Primary practice location

10 Graham Rd W
Ithaca, NY 14850-1055

Mailing address

10 Graham Rd W
Ithaca, NY 14850-1055
Phone (607) 257-5958

Other practice location 1

1290 Trumansburg Rd
Ithaca, NY 14850-1314
Phone (607) 319-5211

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
I20230329001151 NY Practitioner - Nurse Practitioner 6901270115 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F383048-01NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Nov 14, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Nov 14, 2023 Accepting new patients
Northeast Pediatrics & Adolescent Medicine, LLP PastSince Aug 11, 2019 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

400 Kelby St
Fl 9
Fort Lee, NJ 07024

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: caitlin2043@hiemail.healtheconnections.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1700431376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GRAHAM RD W",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501055",
            "telephone_number": "607-257-5958",
            "fax_number": "607-266-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GRAHAM RD W",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501055",
            "telephone_number": "607-257-5958",
            "fax_number": "607-266-7341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1290 Trumansburg Rd",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148501314",
            "country_code": "US",
            "telephone_number": "607-319-5211",
            "fax_number": "607-266-0909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "CAITLIN",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383048-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.