Organization Active NPI

Further Nurse Practitioner in Psychiatry Practice PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • West Babylon, NY
National Provider Identifier
1063358711
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
FURTHER NURSE PRACTITIONER IN PSYCHIATRY PRACTICE PLLC
Practice address
609 Route 109 Ste 2D
West Babylon, NY 11704-5000
Phone
(631) 318-4490
Fax
(631) 983-6132
NPI assigned
Apr 27, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Michael M Tobin, PMHNP-BCNPI 1316450836
Title
Owner/Managing Member
Phone
(631) 318-4490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

609 Route 109 Ste 2D
West Babylon, NY 11704-5000

Mailing address

445 Broad Hollow Rd
Suite 25 #40
Melville, NY 11747
Phone (631) 318-4490

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1063358711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 BROAD HOLLOW RD",
            "address_2": "SUITE 25 #40",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-318-4490",
            "fax_number": "631-983-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 ROUTE 109 STE 2D",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117045000",
            "telephone_number": "631-318-4490",
            "fax_number": "631-983-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FURTHER NURSE PRACTITIONER IN PSYCHIATRY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-26",
        "status": "A",
        "authorized_official_last_name": "TOBIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "631-318-4490",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.