Eva Dziergowska, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403157 Issued in NY

Practice address

363 Route 111
Smithtown, NY 11787-4756

Phone

(631) 209-4255

NPI assigned

Aug 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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.

• Long Island Select Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Central Islip, NY
  • NPI 1043663107
  Medicare reassignment NPD
• Psychiatric Care Medical PLLC

  • Psychiatry Physician
  • Saint James, NY
  • NPI 1952946386
  Medicare reassignment NPD
• Long Island Select Healthcare, Inc.

  • Developmental Disabilities Clinic/Center
  • Central Islip, NY
  • NPI 1891240784
  NPD
• New York Neuromodulation Medical PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1558891135
  NPD (past)

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1194337253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874756",
            "telephone_number": "631-209-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIERGOWSKA",
        "first_name": "EVA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Duran - Ponce, RD, CDE
• April Lynn Duryea-Racanelli, CSW
• DVN Drug Corp
• DVN Drug Corp
• Keith Merrill Dworkin, OD
• E.Lila Augoustiniatos, MD, PC
• E.S. Mango, M.D., P.C.
• Earth and Beauty Bar
• East Main Street Acupuncture PLLC
• Joan Eberlin, RN

• Psychiatric/Mental Health Nurse Practitioner in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.