Individual provider Active NPI

Rebecca Colby-Kreuger

  • Specialist
  • Nyack, NY
National Provider Identifier
1790767010
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
F001113 Issued in NY
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

Updated by the provider on Mar 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
010113OtherNYCONNECTICARE #
3450515OtherNYAETNA HMO #
1899671OtherNYGHI PPO #
CR1113OtherNYATLANTIS HEALTH PLAN #
000000087074OtherNYGHI HMO #
02518261MedicaidNY
366184OtherNYMVP #
7131533OtherNYAETNA PPO #
M0M691OtherNYEMPIRE BCBS #
0D3131OtherNYHEALTHNET #
1000041797OtherNYAFFINITY HEALTH PLAN #
246177OtherNYWELLCARE #

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

LicenseStateTypeSpecialty
001113NYMDSpecialist
F001113NYMDSpecialist

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.

Verify at the official NPI Registry.