Individual provider Active NPI

Takiysha McLeod-Ballard

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1073974143
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401983 Issued in NY
Practice address
726 Quincy St FL 4
Brooklyn, NY 11221-2210
Phone
(347) 826-6167
Fax
(917) 397-3520
NPI assigned
Mar 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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 401983 NY Primary

Addresses

Primary practice location

726 Quincy St FL 4
Brooklyn, NY 11221-2210

Mailing address

32 W Dean St
Freeport, NY 11520-2106
Phone (917) 757-2596

Other practice location 1

535 W 110th St Apt 1E
New York, NY 10025-2021
Phone (212) 280-4740

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
I20171212001892 NY Practitioner - Nurse Practitioner 0749548139 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Housing Works Services II, Inc CurrentSince Nov 2, 2017 Accepting new patients
Orenda Psychiatry PLLC Psychiatric/Mental Health Past Accepting new patients
Ladies of Casa Family Health & Psychiatric NP Services Psychiatric/Mental Health PastSince Oct 6, 2024 Accepting new patients

Locations

57 Willoughby St
Lowr
Brooklyn, NY 11201
Phone (718) 408-6522

57 Willoughby St
Fl 2
Brooklyn, NY 11201
Phone (347) 473-7475

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1073974143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 W DEAN ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202106",
            "telephone_number": "917-757-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 QUINCY ST FL 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112212210",
            "telephone_number": "347-826-6167",
            "fax_number": "917-397-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 W 110th St Apt 1E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100252021",
            "country_code": "US",
            "telephone_number": "212-280-4740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEOD-BALLARD",
        "first_name": "TAKIYSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.