Individual provider Active NPI

Mary Jepson, APRN

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1871927301
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013907 Issued in CA
Practice address
64 Bleecker St # 151
New York, NY 10012-2410
Phone
(302) 313-1584
NPI assigned
Sep 3, 2013
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 005540 CT
Family Nurse Practitioner 363LF0000X 201406741NP-PP OR
Family Nurse Practitioner 363LF0000X 95013907 CA Primary
Registered Nurse 163W00000X 102503 CT

Addresses

Primary practice location

64 Bleecker St # 151
New York, NY 10012-2410

Mailing address

64 Bleecker St # 151
New York, NY 10012-2410
Phone (302) 313-1584

Other identifiers 3

IdentifierTypeStateIssuer
096511MedicaidOR
004236346MedicaidCT
22959MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NY, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150204002240 OR Practitioner - Nurse Practitioner 7810126679 Reassigns benefits to 1 organization
I20230828000482 NY Practitioner - Nurse Practitioner 7810126679 Reassigns benefits to 1 organization
I20230911004254 NC Practitioner - Nurse Practitioner 7810126679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102503CTMDRegistered Nurse
005540CTMDOccupational Therapist
95013907CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Nov 19, 2014 Accepting new patients
Multnomah County Current Accepting new patients
Galileo Medical PC CurrentSince Jul 28, 2023 Accepting new patients
Galileo Medical Group NC PC CurrentSince Jul 28, 2023 Accepting new patients
Multnomah County CurrentSince Nov 19, 2014 Accepting new patients

Locations

315 W 2nd St
Greenville, NC 27834
Phone (252) 507-0588

632 Broadway
New York, NY 10012
Phone (347) 762-7392

64 Bleecker St
New York, NY 10012
Phone (302) 313-1584

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

2020 SE 182nd Ave
Portland, OR 97233
Phone (503) 661-3439

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

Networks

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

Interoperability endpoints

  • Direct secure messaging: mary.jepson@450368864321540.direct.elationemr.com

Organizations & group practices 5

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1871927301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BLEECKER ST # 151",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122410",
            "telephone_number": "302-313-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BLEECKER ST # 151",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122410",
            "telephone_number": "302-313-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPSON",
        "first_name": "MARY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005540",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201406741NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013907",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "102503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096511",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.