Joan Marie Killeen, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Guilderland, NY
NPI 1164064275 · NPPES record last updated Aug 22, 2024
Key facts
- NPI
- 1164064275
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 402875 (NY)
- Practice address
- 2280 Western Ave
Guilderland, NY 12084-9210 - Phone
- (518) 417-1847
- NPI assigned
- Oct 9, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Samaritan Hospital of Troy, New York
Practice addresses (Care Compare)
2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300
Hospital & facility affiliations
- Samaritan Hospital of Troy, New York
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191202001376 | NY | Practitioner - Nurse Practitioner | 0042643249 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 402875 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Peter'S Hospital of the City of Albany | Psychiatry | Current |
Accepting new patients |
| Matters of Mind, Nurse Practitioner in Psychiatry, PLLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| St. Peter'S Hospital of the City of Albany | Psychiatry | Current |
Accepting new patients |
| Samaritan Hospital of Troy, New York | Psychiatry | Current |
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
- jkilleen789314@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 402875 | NY | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | payer.credentialing@sphp.com | Direct | |
| Direct Messaging Address | jmkilleen@proton.me | Direct |
Other providers in Guilderland, NY
- Karner Psychological Associates PC
- Esther J Karp
- Delores Kelley
- Qamar J Khan
- Usman R Khan
- Elaine J Kincaid
- William James Knauer
- John Mark Kowalski
- Pamela F Lacasio
- Ching Yan Phyllis Lam
All providers in Guilderland, NY · Psychiatric/Mental Health Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.