Individual provider Active NPI

Tatyana Poviliunas, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clifton Park, NY
National Provider Identifier
1013503010
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F403011 Issued in NY
Practice address
634 Plank Rd Ste 108
Clifton Park, NY 12065-2033
Phone
(646) 244-6136
NPI assigned
Dec 15, 2020
Last updated
May 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F403011 NY Primary

Addresses

Primary practice location

634 Plank Rd Ste 108
Clifton Park, NY 12065-2033

Mailing address

634 Plank Rd Ste 108
Clifton Park, NY 12065-2033
Phone (646) 244-6136

Other practice location 1

25 Willowbrook Rd
Queensbury, NY 12804-5882
Phone (646) 244-6136

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
I20210218000336 NY Practitioner - Nurse Practitioner 5496160731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2155 State Route 22B
Morrisonville, NY 12962-3417
Phone (518) 563-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F403011NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Services North, Inc. CurrentSince Nov 12, 2020 Accepting new patients
Behavioral Health Services North, Inc. CurrentSince Nov 12, 2020 Accepting new patients
Tatyana Poviliunas, NP in Psychiatry, PLLC Psychiatric/Mental Health Current Accepting new patients

Locations

2155 State Route 22B
Morrisonville, NY 12962
Phone (518) 562-3847

22 US Oval
Ste 218
Plattsburgh, NY 12903
Phone (518) 563-8206

25 Willowbrook Rd
Ste 1
Queensbury, NY 12804
Phone (518) 926-2065

25 Willowbrook Rd
Queensbury, NY 12804
Phone (518) 793-9156

Organizations & group practices 3

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.

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": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1013503010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 PLANK RD STE 108",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652033",
            "telephone_number": "646-244-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 PLANK RD STE 108",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652033",
            "telephone_number": "646-244-6136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Willowbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Queensbury",
            "state": "NY",
            "postal_code": "128045882",
            "country_code": "US",
            "telephone_number": "646-244-6136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POVILIUNAS",
        "first_name": "TATYANA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

Verify at the official NPI Registry.