Individual provider Active NPI

Joann Paoletti, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1164969226
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402621 Issued in NY
Practice address
463 Fashion Ave FL 17
New York, NY 10018-7595
Phone
(917) 408-1668
NPI assigned
Jan 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2019

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 413173-1 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402621 NY Primary

Addresses

Primary practice location

463 Fashion Ave FL 17
New York, NY 10018-7595

Mailing address

77 Chicago Ave
Staten Island, NY 10305-3757
Phone (718) 442-7828

Other practice location 1

77 Chicago Ave
Staten Island, NY 10305-3757
Phone (718) 442-7828

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
I20200317001868 NY Practitioner - Nurse Practitioner 3971931312 Reassigns benefits to 4 organizations
Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

149 Glenwood Ave
Staten Island, NY 10301-4025
Phone (845) 669-7060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
413173-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Young Adult Institute, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Premier Healthcare, Inc. CurrentSince Dec 1, 2021 Accepting new patients
National Neighborhood Counseling Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Century Medical & Dental Center Inc CurrentSince Apr 1, 2021 Accepting new patients
Premier Healthcare, Inc. Current Accepting new patients
Joann Paoletti PHD Psychiatric Nurse Practitioner PLLC CurrentSince Sep 21, 2022 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

770 Flatbush Ave
Brooklyn, NY 11226
Phone (347) 627-3988

7701 13th Ave
Brooklyn, NY 11228
Phone (718) 232-1351

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1164969226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 CHICAGO AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053757",
            "telephone_number": "718-442-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 FASHION AVE FL 17",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187595",
            "telephone_number": "917-408-1668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053757",
            "country_code": "US",
            "telephone_number": "718-442-7828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAOLETTI",
        "first_name": "JOANN",
        "name_prefix": "Dr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-27",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "413173-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.