Individual provider Active NPI

Jaime Cepeda, MD

  • Surgery Physician
  • Middletown, NY
National Provider Identifier
1811932965
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
229029 Issued in NY
Practice address
384 Crystal Run Rd Ste 201
Middletown, NY 10941-4073
Phone
(845) 692-8780
NPI assigned
Jun 20, 2006
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 229029 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

5 Hudson Valley Professional Plaza
Newburgh, NY 12550-3117
Phone (845) 692-8780

Other identifiers 2

IdentifierTypeStateIssuer
02791564MedicaidNY
WNW101OtherNYMEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070410000370 NY Practitioner - General Surgery 9537264155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux15
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Cornwall Hospital Past Accepting new patients
Recoverhealth Medical Services, PLLC Surgery PastSince Mar 21, 2021 Accepting new patients
Bon Secours Community Hospital Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: jamie.cepeda.1@3127.direct.athenahealth.com

Organizations & group practices 4

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 3

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1811932965",
    "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"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Hudson Valley Professional Plaza",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125503117",
            "country_code": "US",
            "telephone_number": "845-692-8780",
            "fax_number": "845-692-3439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEPEDA",
        "first_name": "JAIME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "229029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02791564",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "WNW101",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.