Individual provider Active NPI

Samantha Pia Mehlman

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1245853993
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403158 Issued in NY
Practice address
115 W 30TH St RM 400
New York, NY 10001-4075
Phone
(516) 318-1213
NPI assigned
May 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered Nurse 163WX0200X 682786 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403158 NY Primary

Addresses

Primary practice location

115 W 30TH St RM 400
New York, NY 10001-4075

Mailing address

115 W 30TH St RM 400
New York, NY 10001-4075
Phone (516) 318-1213

Other practice location 1

525 E 68th St
New York, NY 10065-4870
Phone (212) 746-0329

Other practice location 2

241 37th St Fl 6
Brooklyn, NY 11232-2420
Phone (516) 318-1213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
682786NYMDOncology Registered Nurse
403158NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1245853993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W 30TH ST RM 400",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014075",
            "telephone_number": "516-318-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 30TH ST RM 400",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014075",
            "telephone_number": "516-318-1213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E 68th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "212-746-0329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "241 37th St Fl 6",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112322420",
            "country_code": "US",
            "telephone_number": "516-318-1213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHLMAN",
        "first_name": "SAMANTHA",
        "middle_name": "PIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "NY",
            "license": "682786",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.