Individual provider Active NPI

Tuwain Pinky Kolleh, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1083986863
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405539-01 Issued in NY
Practice address
80 Maiden LN
New York, NY 10038-4811
Phone
(212) 683-6700
NPI assigned
Feb 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 649122 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F405539-01 NY Primary

Addresses

Primary practice location

80 Maiden LN
New York, NY 10038-4811

Mailing address

80 Maiden LN
New York, NY 10038-4811
Phone (212) 683-6700

Other practice location 1

122 E 23rd St
New York, NY 10010-4516
Phone (917) 620-8738

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
I20241211001054 NY Practitioner - Nurse Practitioner 4688100837 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
649122NYMDRegistered Nurse
F405539-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orenda Psychiatry PLLC Psychiatric/Mental Health CurrentSince Feb 2, 2026 Accepting new patients

Locations

110 Fieldcrest Ave
Ste 382
Edison, NJ 08837

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

80 5th Ave
Ste 90310
New York, NY 10011

80 5th Ave
New York, NY 10011
Phone (646) 460-0097

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1083986863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MAIDEN LN",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384811",
            "telephone_number": "212-683-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MAIDEN LN",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384811",
            "telephone_number": "212-683-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 E 23rd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104516",
            "country_code": "US",
            "telephone_number": "917-620-8738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLEH",
        "first_name": "TUWAIN",
        "middle_name": "PINKY",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "649122",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405539-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.