Individual provider Active NPI

Joan Marie Killeen, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Guilderland, NY
National Provider Identifier
1164064275
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402875 Issued in NY
Practice address
2280 Western Ave
Guilderland, NY 12084-9210
Phone
(518) 417-1847
NPI assigned
Oct 9, 2019
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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 402875 NY Primary

Addresses

Primary practice location

2280 Western Ave
Guilderland, NY 12084-9210

Mailing address

2280 Western Ave
Guilderland, NY 12084-9210
Phone (518) 417-1847

Other practice location 1

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3374

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct
Direct Messaging Address jmkilleen@proton.me Direct

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
I20191202001376 NY Practitioner - Nurse Practitioner 0042643249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Psychiatry CurrentSince Dec 16, 2019 Accepting new patients
St. Peter's Hospital of the City of Albany Psychiatry CurrentSince Dec 16, 2019 Accepting new patients
St. Peter's Hospital of the City of Albany Psychiatry CurrentSince Dec 16, 2019 Accepting new patients
Matters of Mind, Nurse Practitioner in Psychiatry, PLLC Psychiatric/Mental Health CurrentSince Aug 25, 2024 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

2280 Western Ave
Guilderland, NY 12084
Phone (518) 456-5056

2925 Hamburg St
Ste 1
Schenectady, NY 12303
Phone (518) 357-2909

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: jkilleen789314@direct.trinity-health.org
  • Direct secure messaging: payer.credentialing@sphp.com

Organizations & group practices 4

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.

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": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1164064275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 WESTERN AVE",
            "city": "GUILDERLAND",
            "state": "NY",
            "postal_code": "120849210",
            "telephone_number": "518-417-1847",
            "fax_number": "518-240-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 WESTERN AVE",
            "city": "GUILDERLAND",
            "state": "NY",
            "postal_code": "120849210",
            "telephone_number": "518-417-1847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "JOAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2215 Burdett Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121802466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmkilleen@proton.me",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure, encrypted email",
            "address_1": "2280 Western Ave",
            "city": "Guilderland",
            "state": "NY",
            "country_code": "US",
            "postal_code": "120849210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Guilderland, NY

Sources for this page

Verify at the official NPI Registry.