Individual provider Active NPI

Elizabeth Piccolo, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New City, NY
National Provider Identifier
1184862302
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401153 Issued in NY
Practice address
151 S Main St Ste 306
New City, NY 10956
Phone
(845) 639-0000
Fax
(845) 499-2537
NPI assigned
Jan 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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 F401153 NY Primary

Addresses

Primary practice location

151 S Main St Ste 306
New City, NY 10956

Mailing address

151 S Main St Ste 306
New City, NY 10956-3544
Phone (845) 639-0000

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
I20100107000259 NY Practitioner - Nurse Practitioner 2062553449 Reassigns benefits to 1 organization
Practice locations: New City, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

151 S Main St
Suite 306
New City, NY 10956-3516
Phone (845) 639-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F401153NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joy M Gavigan NP in Psychiatry PLLC CurrentSince Mar 13, 2022 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Feb 26, 2025 Accepting new patients
The Mental Health Association of Westchester County - Social Care Network Past Accepting new patients

Locations

151 S Main St
Ste 306
New City, NY 10956
Phone (845) 624-1994

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

Organizations & group practices 3

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": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1184862302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 S MAIN ST STE 306",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109563544",
            "telephone_number": "845-639-0000",
            "fax_number": "845-499-2537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S MAIN ST STE 306",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "10956",
            "telephone_number": "845-639-0000",
            "fax_number": "845-499-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCOLO",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.