Individual provider Active NPI

Vishanti Jaimangal, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baldwin, NY
National Provider Identifier
1083507420
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
407115 Issued in NY
Practice address
2692 Grand Ave
Baldwin, NY 11510-3913
Phone
(516) 849-9313
NPI assigned
Jun 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 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 407115 NY Primary

Addresses

Primary practice location

2692 Grand Ave
Baldwin, NY 11510-3913

Mailing address

2692 Grand Ave
Baldwin, NY 11510-3913
Phone (516) 849-9313

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
I20260501002890 NY Practitioner - Nurse Practitioner 2668940222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Priyadarshan Bajpayi MD PCGroup PAC ID 6608118179, 13 clinicians

Practice addresses (Care Compare)

5550 Merrick Rd
Massapequa, NY 11758-6238
Phone (631) 673-3233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
407115NYMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

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": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1083507420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2692 GRAND AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103913",
            "telephone_number": "516-849-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2692 GRAND AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103913",
            "telephone_number": "516-849-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIMANGAL",
        "first_name": "VISHANTI",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

Verify at the official NPI Registry.