Active NPI
Rebecca Colby-Kreuger
- Specialist
- Nyack, NY
National Provider Identifier
1790767010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- F001113
- Practice address
- 258 High Ave
Nyack, NY 10960-2407 - Phone
- (845) 353-1441
- Fax
- (845) 353-1987
- NPI assigned
- Nov 14, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | F001113 | NY | Primary |
Addresses
Primary practice location
258 High Ave
Nyack, NY 10960-2407
Mailing address
258 High Ave
Nyack, NY 10960-2407
Phone (845) 353-1441
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010113 | Other | NY | CONNECTICARE # |
| 3450515 | Other | NY | AETNA HMO # |
| 1899671 | Other | NY | GHI PPO # |
| CR1113 | Other | NY | ATLANTIS HEALTH PLAN # |
| 000000087074 | Other | NY | GHI HMO # |
| 02518261 | Medicaid | NY | |
| 366184 | Other | NY | MVP # |
| 7131533 | Other | NY | AETNA PPO # |
| M0M691 | Other | NY | EMPIRE BCBS # |
| 0D3131 | Other | NY | HEALTHNET # |
| 1000041797 | Other | NY | AFFINITY HEALTH PLAN # |
| 246177 | Other | NY | WELLCARE # |
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
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001113 | NY | MD | Specialist |
| F001113 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236211200000",
"number": "1790767010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 HIGH AVE",
"city": "NYACK",
"state": "NY",
"postal_code": "109602407",
"telephone_number": "845-353-1441",
"fax_number": "845-353-1987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 HIGH AVE",
"city": "NYACK",
"state": "NY",
"postal_code": "109602407",
"telephone_number": "845-353-1441",
"fax_number": "845-353-1987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBY-KREUGER",
"first_name": "REBECCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-14",
"last_updated": "2009-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "F001113",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE #",
"identifier": "010113",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO #",
"identifier": "3450515",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PPO #",
"identifier": "1899671",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATLANTIS HEALTH PLAN #",
"identifier": "CR1113",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI HMO #",
"identifier": "000000087074",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02518261",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP #",
"identifier": "366184",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO #",
"identifier": "7131533",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS #",
"identifier": "M0M691",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET #",
"identifier": "0D3131",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AFFINITY HEALTH PLAN #",
"identifier": "1000041797",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE #",
"identifier": "246177",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.