Michelle Tavares, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

405859 Issued in NY

Practice address

37 Everts Ave
Glens Falls, NY 12804-2040

Phone

(518) 793-4700

Fax

(518) 793-6325

NPI assigned

Apr 20, 2021

Last updated

Oct 10, 2024By the provider in NPPES

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Work and Independence IncGroup PAC ID 2961462924, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ellis Hospital Hospital, Schenectady, NY, CCN 330153
• Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Work and Independence, Inc.

  • Developmental Disabilities Clinic/Center
  • Glens Falls, NY
  • NPI 1114131075
  Medicare reassignment Care Compare group NPD
• Community, Work, and Independence, Inc.

  • Community/Behavioral Health Agency
  • Glens Falls, NY
  • NPI 1770837460
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Care Compare affiliation
• Glens Falls Hospital Inc

  • General Acute Care Hospital
  • Glens Falls, NY
  • NPI 1871606764
  Care Compare affiliation

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1265013312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 EVERTS AVE",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128042040",
            "telephone_number": "518-793-4700",
            "fax_number": "518-793-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 EVERTS AVE",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128042040",
            "telephone_number": "518-793-4700",
            "fax_number": "518-793-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARES",
        "first_name": "MICHELLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly H Symonds, LCSW-R
• Andrea Szabo
• Geronimo Tapawan, MD
• Sierra Tarantino
• Matthew Tarello, M.D.
• Ben Frazier Taylor, M.D., PH.D.
• Victoria Taylor, DMD
• William A Tedesco, M.D.
• Terry L Walton Doctor of Optometry PC (Associates in Vision Care)
• Sara Tessitore Volkmann, NP

• Psychiatric/Mental Health Nurse Practitioner in Glens Falls, NY
• Providers in Glens Falls, 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 Oct 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.