Jebediah Daniel Walston, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

355499 Issued in NY

Practice address

28 Rykowski LN
Middletown, NY 10941-4018

Phone

(845) 692-3376

NPI assigned

Dec 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Drexel University College of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Schweiger Dermatology PLLCGroup PAC ID 5991947160, 254 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

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.

• Schweiger Dermatology PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1831438662
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1912714577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MAPLE AVE APT 1",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901023",
            "telephone_number": "717-758-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 RYKOWSKI LN",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414018",
            "telephone_number": "845-692-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSTON",
        "first_name": "JEBEDIAH",
        "middle_name": "DANIEL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shari Wallace, M.D.
• Sheila Brady Wallace, P.T
• Diana Walls
• Sara Janine Walsh, RN
• Glenn C Walski, R.PH.
• Kelly Anne Walter, TEACHER
• Nicole Corinne Walter, OTA
• Ezra Waltermaurer, RN
• Joelle L Walz, MAED
• Hannah Kathleen Warner

• Family Nurse Practitioner in Middletown, NY
• Providers in Middletown, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.