| Esopus Medical, Pc | |
|
105 Woodcrest Dr Rifton NY 12471-7200 | |
| (845) 658-7763 | |
| Not Available |
| Full Name | Esopus Medical, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 105 Woodcrest Dr, Rifton, New York |
| Authorized Official Name and Position | Monika R.a. Mommsen (PRESIDENT) |
| Authorized Official Contact | 8456587763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Esopus Medical, Pc 10 Hellbrook Ln Ulster Park NY 12487-5209 Ph: (845) 658-7763 | Esopus Medical, Pc 105 Woodcrest Dr Rifton NY 12471-7200 Ph: (845) 658-7763 |
| NPI Number | 1295701787 |
|---|---|
| Provider Enumeration Date | 02/24/2006 |
| Last Update Date | 10/10/2022 |
| Medicare PECOS PAC ID | 1254304074 |
|---|---|
| Medicare Enrollment ID | O20040818001017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295701787 | NPI | - | NPPES |
| 02533053 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 52862 (New York) | Primary |
| Provider Name | Sara Jessie Thomson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518944321 PECOS PAC ID: 2466427935 Enrollment ID: I20040827001149 |
| Provider Name | Jonathan L Zimmerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841266475 PECOS PAC ID: 0749255248 Enrollment ID: I20040828000089 |
| Provider Name | Monika Mommsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376519926 PECOS PAC ID: 7810960648 Enrollment ID: I20040828000117 |
| Provider Name | Anneke S Maendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841277647 PECOS PAC ID: 1658346440 Enrollment ID: I20091104000450 |
| Provider Name | Jacob H Hofer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336306497 PECOS PAC ID: 2264600816 Enrollment ID: I20110726000368 |
| Provider Name | Christopher Michael Maendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447228002 PECOS PAC ID: 9739154527 Enrollment ID: I20140306001104 |
| Provider Name | Amelia Lisa Maas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316205420 PECOS PAC ID: 9739497959 Enrollment ID: I20151007001955 |