Individual provider Active NPI

Penelope Josephine Guccione, FNP

  • Family Nurse Practitioner
  • Newburgh, NY
National Provider Identifier
1861875114
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340253 Issued in NY
Practice address
147 Lake St
Newburgh, NY 12550
Phone
(845) 563-8000
NPI assigned
Jul 6, 2015
Last updated
Dec 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 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 F340253 NY Primary
Registered Nurse 163W00000X 686090-1 NY

Addresses

Primary practice location

147 Lake St
Newburgh, NY 12550

Mailing address

2570 Route 9W
Suite 10
Cornwall, NY 12518-1323
Phone (845) 220-3100

Other identifiers 1

IdentifierTypeStateIssuer
04393257MedicaidNY

Other names 1

  • Miss Penelope Josephine Smith Former name

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
I20160315000916 NY Practitioner - Nurse Practitioner 7012213200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Family HealthcareGroup PAC ID 4880610393, 67 clinicians

Practice addresses (Care Compare)

147 Lake St
Newburgh, NY 12550-5263
Phone (845) 563-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
686090-1NYMDRegistered Nurse
340253NYMDInternal Medicine Physician
F340253NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Family Healthcare CurrentSince Feb 8, 2016 Accepting new patients
Cornerstone Family Healthcare CurrentSince Feb 8, 2016 Accepting new patients

Locations

2570 US Highway 9W
Ste 10
Cornwall, NY 12518
Phone (845) 220-3100

147 Lake St
Newburgh, NY 12550

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCECD
  • Direct secure messaging: penelope.guccione@csfh.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1861875114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ROUTE 9W",
            "address_2": "SUITE 10",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181323",
            "telephone_number": "845-220-3100",
            "fax_number": "845-534-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 LAKE ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "12550",
            "telephone_number": "845-563-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUCCIONE",
        "first_name": "PENELOPE",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340253",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "686090-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04393257",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENELOPE",
            "last_name": "SMITH",
            "middle_name": "JOSEPHINE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.