Individual provider Active NPI

Ivelisse Juliana Capellan, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1215694104
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405446-01 Issued in NY
Practice address
629 W 185TH St
New York, NY 10033-3102
Phone
(212) 543-3500
Fax
(212) 568-0051
NPI assigned
Nov 26, 2021
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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 F405446-01 NY Primary

Addresses

Primary practice location

629 W 185TH St
New York, NY 10033-3102

Mailing address

629 W 185TH St FL 3
New York, NY 10033-3102
Phone (212) 543-3500

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
I20250514000078 NY Practitioner - Nurse Practitioner 4587182571 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F405446-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
M and M Psychiatric Nurse Practitioner Services PLLC Psychiatric/Mental Health CurrentSince Sep 8, 2025 Accepting new patients
Fernando Taveras, MD PC CurrentSince Mar 7, 2025 Accepting new patients
Mih Experience LTD PastSince Aug 25, 2025 Accepting new patients
Compassionate Medical Care PLLC PastSince Jul 1, 2024 Accepting new patients
RR Medical, P.C. PastSince Jul 1, 2024 Accepting new patients

Locations

495 Flatbush Ave
Ste 33
Brooklyn, NY 11225
Phone (516) 299-8698

629 W 185th St
New York, NY 10033
Phone (212) 781-9223

629 W 185th St
#3
New York, NY 10033
Phone (212) 543-3500

629 W 185th St
Fl 3
New York, NY 10033
Phone (212) 543-3500

629 W 185th St
Ste 301
New York, NY 10033

Interoperability endpoints

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

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": "1637884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1215694104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 W 185TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333102",
            "telephone_number": "212-543-3500",
            "fax_number": "212-568-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 W 185TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333102",
            "telephone_number": "212-543-3500",
            "fax_number": "212-568-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPELLAN",
        "first_name": "IVELISSE",
        "middle_name": "JULIANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-26",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405446-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.