Individual provider Active NPI

Mary M Herne, FNP-C

  • Family Nurse Practitioner
  • Hogansburg, NY
National Provider Identifier
1730675190
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343747 Issued in NY
Practice address
412 State Route 37
Hogansburg, NY 13655-3109
Phone
(518) 358-3141
NPI assigned
Jul 9, 2018
Last updated
Nov 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 343747 NY Primary
Registered Nurse 163W00000X 646881 NY

Addresses

Primary practice location

412 State Route 37
Hogansburg, NY 13655-3109

Mailing address

35 Clover Park Dr Apt 2
Rochester, NY 14618-4533
Phone (623) 512-2488

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
I20181206000364 NY Practitioner - Nurse Practitioner 5092059725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Regis Mohawk TribeGroup PAC ID 5799748547, 11 clinicians

Practice addresses (Care Compare)

404 State Route 37
Akwesasne, NY 13655-3109
Phone (518) 358-3141

412 State Route 37
Hogansburg, NY 13655-3109
Phone (518) 358-3141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
646881NYMDRegistered Nurse
343747NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Regis Mohawk Tribe CurrentSince Oct 19, 2018 Accepting new patients

Locations

404 State Route 37
Hogansburg, NY 13655
Phone (518) 358-3141

412 State Route 37
Hogansburg, NY 13655
Phone (518) 358-3141

Interoperability endpoints

  • Direct secure messaging: mherne@hiemail.healtheconnections.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1730675190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CLOVER PARK DR APT 2",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184533",
            "telephone_number": "623-512-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 STATE ROUTE 37",
            "city": "HOGANSBURG",
            "state": "NY",
            "postal_code": "136553109",
            "telephone_number": "518-358-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNE",
        "first_name": "MARY",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343747",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "646881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hogansburg, NY

Sources for this page

Verify at the official NPI Registry.