Individual provider Active NPI

Nisha Pradeep

  • Psychiatric/Mental Health Nurse Practitioner
  • Garden City, NY
National Provider Identifier
1023455995
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401586-1 Issued in NY
Practice address
500 Old Country Rd Ste 315
Garden City, NY 11530-1944
Phone
(516) 424-8387
NPI assigned
May 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 F401586-1 NY Primary

Addresses

Primary practice location

500 Old Country Rd Ste 315
Garden City, NY 11530-1944

Mailing address

89 Central Ave
Garden City Park, NY 11040-4134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20150924001826 NY Practitioner - Nurse Practitioner 7113235144 Reassigns benefits to 3 organizations
Practice locations: Garden City Park, NY; New York, NY
I20240723001888 NY Practitioner - Nurse Practitioner 7113235144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Buffalo School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Manas NP-Psychiatry PCGroup PAC ID 9537605803, 2 clinicians

Practice addresses (Care Compare)

500 Old Country Rd
Suite 315
Garden City, NY 11530-1901

500 Old Country Rd
Suite 315
Garden City, NY 11530-1944
Phone (516) 424-8387

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F401586-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rivia Medical PLLC CurrentSince Dec 6, 2023 Accepting new patients
Manas NP-Psychiatry P.C. Psychiatric/Mental Health CurrentSince Apr 15, 2024 Accepting new patients
The Long Island Home CurrentSince Aug 1, 2015 Accepting new patients
The Long Island Home CurrentSince Aug 1, 2015 Accepting new patients
Rivia Medical PLLC Psychiatric/Mental Health CurrentSince Dec 6, 2023 Accepting new patients
Simi Joseph Nurse Practitioner in Psychiatry P C Psychiatric/Mental Health PastSince Sep 12, 2020 Accepting new patients

Locations

400 Sunrise Hwy
Amityville, NY 11701
Phone (631) 264-4000

500 Old Country Rd
Ste 315
Garden City South, NY 11530
Phone (516) 243-9480

274 Madison Ave
Rm 1501
New York, NY 10016
Phone (212) 202-1773

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1023455995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 CENTRAL AVE",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110404134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OLD COUNTRY RD STE 315",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301944",
            "telephone_number": "516-424-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADEEP",
        "first_name": "NISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-31",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401586-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.