Individual provider Active NPI

Alethea K Shepardson, RNP

  • Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1881783280
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F331744 Issued in NY
Practice address
Clinical Diabetes Center
3411 Wayne Avenue
Bronx, NY 10457
Phone
(718) 920-5544
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F331744 NY Primary

Addresses

Primary practice location

Clinical Diabetes Center
3411 Wayne Avenue
Bronx, NY 10457

Mailing address

250 W 94TH St
Apt. 14J
New York, NY 10025-6954
Phone (718) 920-5544

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
I20080110000444 NY Practitioner - Nurse Practitioner 3274621388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (914) 378-6148

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F331744NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 1, 2006 Accepting new patients
Montefiore Medical Center CurrentSince Jan 1, 2006 Accepting new patients

Locations

1650 Grand Concourse
#C
Bronx, NY 10457
Phone (718) 294-7104

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

111 E 210th St
Bronx, NY 10467

3411 Wayne Ave
Fl 6
Bronx, NY 10467
Phone (718) 918-5820

3411 Wayne Ave
Bronx, NY 10467
Phone (718) 920-2680

Networks

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

Interoperability endpoints

  • Direct secure messaging: ashepard@montefioredirect.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881783280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 94TH ST",
            "address_2": "APT. 14J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256954",
            "telephone_number": "718-920-5544",
            "fax_number": "718-920-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLINICAL DIABETES CENTER",
            "address_2": "3411 WAYNE AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-920-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARDSON",
        "first_name": "ALETHEA",
        "middle_name": "K",
        "credential": "RNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F331744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.