NPIMap

Organization Active NPI

Psyprobill, LLC

  • Community/Behavioral Health Agency
  • Newburgh, NY
National Provider Identifier
1184076358
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
154287 Issued in NY
Legal business name
PSYPROBILL, LLC
Practice address
633 Gidney Ave
Suite 5
Newburgh, NY 12550-2800
Phone
(845) 569-2900
Fax
(866) 619-5710
NPI assigned
Jul 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
Wendy KellerNPI 1467534925
Title
Owner
Phone
(845) 569-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 154287 NY Primary

Addresses

Primary practice location

633 Gidney Ave
Suite 5
Newburgh, NY 12550-2800

Mailing address

633 Gidney Ave
Suite 5
Newburgh, NY 12550-2800
Phone (845) 569-2900

Other names 1

  • Behavioral Health Management Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170331000006 NY Part B Supplier - Clinic/Group Practice 5890070080 Receives reassigned benefits from 12 practitioners
Practice locations: Newburgh, NY

National Provider Directory

National Provider Directory

Locations

633 Gidney Ave
Newburgh, NY 12550

633 Gidney Ave
Ste 5
Newburgh, NY 12550
Phone (845) 242-8375

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1184076358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 GIDNEY AVE",
            "address_2": "SUITE 5",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502800",
            "telephone_number": "845-569-2900",
            "fax_number": "866-619-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GIDNEY AVE",
            "address_2": "SUITE 5",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502800",
            "telephone_number": "845-569-2900",
            "fax_number": "866-619-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYPROBILL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-569-2900"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "154287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health Management Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.