Individual provider Active NPI

Amy L Kidney, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • Bethpage, NY
National Provider Identifier
1710201371
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
F360494 Issued in NY
Practice address
4230 Hempstead Tpke Ste 208
Bethpage, NY 11714-5700
Phone
(516) 735-7900
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X F360494 NY Primary
Advanced Practice Midwife 367A00000X 001059 NY

Addresses

Primary practice location

4230 Hempstead Tpke Ste 208
Bethpage, NY 11714-5700

Mailing address

4230 Hempstead Tpke Ste 208
Bethpage, NY 11714-5700
Phone (516) 735-7900

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
I20110321000330 NY Practitioner - Nurse Practitioner 0446433098 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001059NYMDAudiologist
F360494NYMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peyman Zandieh, MD PC CurrentSince Dec 26, 2010 Accepting new patients

Locations

4230 Hempstead Tpke
Ste 208
Bethpage, NY 11714
Phone (516) 735-5323

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1710201371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 HEMPSTEAD TPKE STE 208",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145700",
            "telephone_number": "516-735-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HEMPSTEAD TPKE STE 208",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145700",
            "telephone_number": "516-735-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDNEY",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F360494",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "001059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.