Individual provider Active NPI

Patricia Irene Mutterer, NPP (NURSE PRACTI

  • Psychiatric/Mental Health Nurse Practitioner
  • Albany, NY
National Provider Identifier
1114933165
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400332-01 Issued in NY
Practice address
260 South Pearl Street
Albany, NY 12202-1809
Phone
(518) 447-4555
Fax
(518) 447-4661
NPI assigned
Jul 31, 2006
Last updated
Aug 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F400332-01 NY Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 288683-1 NY

Addresses

Primary practice location

260 South Pearl Street
Albany, NY 12202-1809

Mailing address

4 Atrium Drive
Suite 100
Albany, NY 12205-1441
Phone (518) 374-0295

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
I20050720000142 NY Practitioner - Nurse Practitioner 9032146261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

260 S Pearl St
Albany, NY 12202-1809
Phone (518) 447-4555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288683-1NYMDPsychiatric/Mental Health Registered Nurse
F400332-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albany County CurrentSince Jul 1, 2015 Accepting new patients
Albany County CurrentSince Jul 1, 2015 Accepting new patients

Locations

260 S Pearl St
Albany, NY 12202
Phone (518) 447-4550

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1114933165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ATRIUM DRIVE",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051441",
            "telephone_number": "518-374-0295",
            "fax_number": "518-377-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SOUTH PEARL STREET",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122021809",
            "telephone_number": "518-447-4555",
            "fax_number": "518-447-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTERER",
        "first_name": "PATRICIA",
        "middle_name": "IRENE",
        "name_prefix": "Miss",
        "credential": "NPP (NURSE PRACTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400332-01",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "288683-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.