Fabio Leonidas Urresta, MD, MS

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

247163 Issued in NY

Practice address

3 Newcastle Rd
Halfmoon, NY 12065-6123

Phone

(518) 724-5151

Fax

(518) 207-9078

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

Locations

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.

• New Virtual Medicine, PLLC

  • Psychiatry Physician
  • Halfmoon, NY
  • NPI 1891946323
  Medicare reassignment NPD Authorized official
• Genesis Medical Health PC

  • General Practice Physician
  • Spring Valley, NY
  • NPI 1295043099

  Psychiatry

  NPD (past)
• Pinnacle Behavioral Health Ipa PLLC

  • Mental Health Counselor
  • Albany, NY
  • NPI 1447276720
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1104987064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEWCASTLE RD",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120656123",
            "telephone_number": "518-724-5151",
            "fax_number": "518-207-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 NEWCASTLE RD",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120656123",
            "telephone_number": "518-724-5151",
            "fax_number": "518-207-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URRESTA",
        "first_name": "FABIO",
        "middle_name": "LEONIDAS",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "247163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "05446216",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "6022352",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SHIELD",
            "identifier": "0046572",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "1891946323",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "533029",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "605560",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NORTHEASTERN NEW YORKI",
            "identifier": "000417902002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "1104987064",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Howard Swalsky
• Keith Swensen
• Jillian Hope Szczepanski
• Brittany Taylor
• Laverne Karen Turner, LPN
• Nicole A Valente
• Heather Valk, LDO
• Maria B Valli, AU.D.
• Madelynn Ann Valu, RD
• Deanna Veet

• Psychiatry Physician in Halfmoon, NY
• Providers in Halfmoon, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.