Individual provider Active NPI

Liana Alam, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Princeton, NJ
National Provider Identifier
1063298768
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405263 Issued in NY
Practice address
235 Mather Ave
Princeton, NJ 08540-6440
Phone
(609) 508-7180
NPI assigned
Sep 7, 2023
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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 F405263 NY Primary

Addresses

Primary practice location

235 Mather Ave
Princeton, NJ 08540-6440

Mailing address

235 Mather Ave
Princeton, NJ 08540-6440
Phone (609) 508-7180

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
I20240226000174 NY Practitioner - Nurse Practitioner 6507201985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

1037 Main St
Peekskill, NY 10566-2913
Phone (914) 734-8800

1200 Brown St
Peekskill, NY 10566-2913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F405263NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Jan 22, 2024 Accepting new patients
Sun River Health Inc CurrentSince Jan 22, 2024 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1063298768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 MATHER AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406440",
            "telephone_number": "609-508-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MATHER AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406440",
            "telephone_number": "609-508-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAM",
        "first_name": "LIANA",
        "name_prefix": "Miss",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.