Individual provider Active NPI

Selina Jean Lenetsky, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ithaca, NY
National Provider Identifier
1265130967
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
404989 Issued in NY
Practice address
101 Harris B Dates Dr
Ithaca, NY 14850-1383
Phone
(607) 252-3248
Fax
(607) 274-4130
NPI assigned
Feb 21, 2023
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 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 404989 NY Primary
Emergency Registered Nurse 163WE0003X 750794 NY

Addresses

Primary practice location

101 Harris B Dates Dr
Ithaca, NY 14850-1383

Mailing address

101 Harris B Dates Dr
Ithaca, NY 14850-1383
Phone (607) 252-3248

Other names 1

  • Selina Jean Markes Former name

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
I20230809000873 NY Practitioner - Nurse Practitioner 1850753732 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayuga Medical Center at IthacaGroup PAC ID 7214847367, 34 clinicians
Tioga CountyGroup PAC ID 6709786916, 7 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4443

1062 State Route 38
Owego, NY 13827-3209
Phone (607) 687-4000

PO Box
Suite 177
Owego, NY 13827-0177

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
750794NYMDEmergency Registered Nurse
404989NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tioga County Health Department CurrentSince Oct 14, 2025 Accepting new patients
Tioga County Psychiatric/Mental Health Current Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Jul 10, 2023 Accepting new patients
Tioga County CurrentSince Oct 14, 2025 Accepting new patients
Cayuga Pathology PLLC Current Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Jul 10, 2023 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients

Locations

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

1062 State Route 38
Owego, NY 13827
Phone (607) 687-0200

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1265130967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HARRIS B DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-252-3248",
            "fax_number": "607-274-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS B DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-252-3248",
            "fax_number": "607-274-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENETSKY",
        "first_name": "SELINA",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-10-06",
        "certification_date": "2023-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404989",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NY",
            "license": "750794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELINA",
            "last_name": "MARKES",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.