Sandra Beaudouin, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F405339-01 Issued in NY

Practice address

5 Meadow LN
Freeport, NY 11520-1002

Phone

(516) 974-6057

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ahava Medical and Rehabilitation Center, LLC

  • Rehabilitation Practitioner
  • Brooklyn, NY
  • NPI 1184878274
  Medicare reassignment NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1023667243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MEADOW LN",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201002",
            "telephone_number": "516-974-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEADOW LN",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201002",
            "telephone_number": "516-974-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDOUIN",
        "first_name": "SANDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341902-01",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405339-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shameeka Baston, RN
• Patricia Batus, LMSW
• Bay Rehab Physical Therapy PC
• Dana Bazemore-Jolly, LMSW
• BCT Dental PLLC
• Kenneth J Becker, MD
• Marilyn M Bell, M.S.,ED.
• Gregory Robert Bellantonio, MSW
• Danielle Ben-Horin, MS.ED, BCBA, LBA
• Lauren Marie Bennett, LMSW

• Psychiatric/Mental Health Nurse Practitioner in Freeport, NY
• Providers in Freeport, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.