Individual provider Active NPI

Karen Ann-Marie Wilson, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Hawthorne, NY
National Provider Identifier
1134499676
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
404223 Issued in NY
Practice address
265 Saw Mill River Rd
Hawthorne, NY 10532-1509
Phone
(914) 495-4500
Fax
(914) 328-3166
NPI assigned
Dec 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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 597177-1 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 404223 NY Primary

Addresses

Primary practice location

265 Saw Mill River Rd
Hawthorne, NY 10532-1509

Mailing address

265 Saw Mill River Rd
Hawthorne, NY 10532-1509
Phone (914) 336-7103

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
I20221130002582 NY Practitioner - Nurse Practitioner 5698143360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nysarc Inc Westchester County ChapterGroup PAC ID 1759272206, 9 clinicians

Practice addresses (Care Compare)

265 Saw Mill River Rd
FL 3
Hawthorne, NY 10532-1509
Phone (914) 495-4487

Hospital & facility affiliations

  • White Plains Hospital Center Hospital, White Plains, NY, CCN 330304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
597177-1NYMDRegistered Nurse
404223NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc Westchester County Chapter CurrentSince Nov 3, 2022 Accepting new patients

Locations

265 Saw Mill River Rd
Hawthorne, NY 10532
Phone (914) 495-4470

265 Saw Mill River Rd
Fl 3
Hawthorne, NY 10532
Phone (914) 495-4487

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1134499676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 SAW MILL RIVER RD",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105321509",
            "telephone_number": "914-336-7103",
            "fax_number": "914-328-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 SAW MILL RIVER RD",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105321509",
            "telephone_number": "914-495-4500",
            "fax_number": "914-328-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAREN",
        "middle_name": "ANN-MARIE",
        "name_prefix": "Miss",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "597177-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.