Individual provider Active NPI

Jody Cepeda, FNP

  • Family Nurse Practitioner
  • Middletown, NY
National Provider Identifier
1801967484
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334584-1 Issued in NY
Practice address
384 Crystal Run Rd Ste 201
Middletown, NY 10941-4073
Phone
(845) 692-8780
Fax
(845) 692-3439
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F334584-1 NY Primary

Addresses

Primary practice location

384 Crystal Run Rd Ste 201
Middletown, NY 10941-4073

Mailing address

384 Crystal Run Rd Ste 201
Middletown, NY 10941-4073
Phone (845) 692-8780

Other practice location 1

460 Gidney Ave
Newburgh, NY 12550-3117
Phone (845) 692-8780

Other identifiers 1

IdentifierTypeStateIssuer
F334584-1OtherNYLIC#

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
I20070109000088 NY Practitioner - Nurse Practitioner 3971503335 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri State Surgical Associates PLLCGroup PAC ID 1254330509, 4 clinicians

Practice addresses (Care Compare)

384 Crystal Run Rd
Suite 201
Middletown, NY 10941-4073
Phone (845) 692-8780

Hospital & facility affiliations

  • Bon Secours Community Hospital Hospital, Port Jervis, NY, CCN 330135
  • Montefiore St Luke'S Cornwall Hospital, Newburgh, NY, CCN 330264

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F334584-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri State Surgical Associates PLLC CurrentSince Apr 11, 2010 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Sep 1, 2020 Accepting new patients
Acute Care Surgery Medical Group, Inc. CurrentSince Aug 1, 2015 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Sep 1, 2020 Accepting new patients
Anesthesia Associates of St. Francis, P.C Past Accepting new patients
Recoverhealth Medical Services, PLLC PastSince Dec 31, 2023 Accepting new patients
Eastern Pain Medicine PC Past Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

384 Crystal Run Rd
Ste 201
Middletown, NY 10941
Phone (845) 692-8780

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

460 Gidney Ave
Newburgh, NY 12550
Phone (845) 458-4700

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

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

Interoperability endpoints

  • Direct secure messaging: jody.machugh.1@3127.direct.athenahealth.com

Organizations & group practices 7

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.

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1801967484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 CRYSTAL RUN RD STE 201",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414073",
            "telephone_number": "845-692-8780",
            "fax_number": "845-692-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 CRYSTAL RUN RD STE 201",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414073",
            "telephone_number": "845-692-8780",
            "fax_number": "845-692-3439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Gidney Ave",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125503117",
            "country_code": "US",
            "telephone_number": "845-692-8780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEPEDA",
        "first_name": "JODY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334584-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC#",
            "identifier": "F334584-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.