Irmina Fisk

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

406241 Issued in NY

Practice address

325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923

Phone

(888) 279-0002

NPI assigned

Nov 17, 2016

Reactivated

Dec 22, 2023

Last updated

Apr 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 3

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

Other, 2023

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

East Point Medical PCGroup PAC ID 0749690741, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DCFCDD/Endpoint/DCFCDD
• Direct secure messaging: irmina.fisk.1@22469.direct.athenahealth.com

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.

• East Point Medical PC

  • Family Medicine Physician
  • Maspeth, NY
  • NPI 1518571751

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group 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
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1033651336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13310 LARSEN LN APT 203",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662133419",
            "telephone_number": "619-792-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N SAINT PAUL ST STE 3100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013923",
            "telephone_number": "888-279-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2415 E Camelback Rd # 68",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164288",
            "country_code": "US",
            "telephone_number": "888-279-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISK",
        "first_name": "IRMINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "deactivation_date": "2023-11-05",
        "reactivation_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-82733-041",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "308031",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1162549",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406241",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "95101694",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "406241",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "308031",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "1162549",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Rose Fisher, FNP-C
• Sierra Lee Fisher, M.D.
• Suzanne D Fisher, MD
• Thomas Boone Fisher, MD
• Robin Lynn Fishman, MS, LPC-S
• Fit and Faithful Living Inc.
• Fit for Him, LLC
• Janine Annette Fitch, LCSW-S
• Kimberly Ann Fite-Thurston, LCSW
• Fitstar Physical Therapy

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.
• 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.