Individual provider Active NPI

Jean Pahima

  • Psychiatric/Mental Health Nurse Practitioner
  • Sleepy Hollow, NY
National Provider Identifier
1215578281
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F404624 Issued in NY
Practice address
701 N Broadway
Sleepy Hollow, NY 10591-1096
Phone
(914) 366-3000
NPI assigned
Oct 1, 2019
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F404624 NY Primary
Registered Nurse 163W00000X 692204 NY

Addresses

Primary practice location

701 N Broadway
Sleepy Hollow, NY 10591-1096

Mailing address

114 W 114TH St Apt 5D
New York, NY 10026-3074

Other practice location 1

1727 Amsterdam Ave Fl 4
New York, NY 10031-4611
Phone (212) 862-0054

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
I20240419000513 NY Practitioner - Nurse Practitioner 1456724319 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
692204NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Symphony Medical PC CurrentSince Mar 18, 2024 Accepting new patients
Symphony Medical PC Current Accepting new patients
Symphony Medical PC CurrentSince Mar 18, 2024 Accepting new patients
Heritage Health and Housing, Inc Past Accepting new patients

Locations

2 Park Ave
Yonkers, NY 10703
Phone (914) 964-7723

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23390/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jpahima695737@nychhc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1215578281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W 114TH ST APT 5D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N BROADWAY",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105911096",
            "telephone_number": "914-366-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1727 Amsterdam Ave Fl 4",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100314611",
            "country_code": "US",
            "telephone_number": "212-862-0054",
            "fax_number": "718-551-0810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAHIMA",
        "first_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-01",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404624",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "692204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sleepy Hollow, NY

Sources for this page

Verify at the official NPI Registry.