Individual provider Active NPI

Kimberly Marie Preshlock, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Farmingdale, NY
National Provider Identifier
1265711386
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
406708 Issued in NY
Practice address
150 Merritts Rd
Farmingdale, NY 11735-3216
Phone
(516) 668-6853
NPI assigned
Aug 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 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 406708 NY Primary

Addresses

Primary practice location

150 Merritts Rd
Farmingdale, NY 11735-3216

Mailing address

150 Merritts Rd
Farmingdale, NY 11735-3216
Phone (516) 668-6853

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
I20250807000336 NY Practitioner - Nurse Practitioner 5799283016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heart and Soul Community CounselingGroup PAC ID 1951644657, 8 clinicians
North Shore Psychiatric Consultants PCGroup PAC ID 1456240928, 8 clinicians

Practice addresses (Care Compare)

1400 Wantagh Ave
Suite L2
Wantagh, NY 11793-2210
Phone (516) 559-0194

180 E Main St
Suite 302
Smithtown, NY 11787-2811
Phone (631) 265-6868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
406708NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Psychiatric Consultants PC CurrentSince Sep 11, 2025 Accepting new patients
Heart & Soul Community Counseling Psychiatric/Mental Health CurrentSince Jun 23, 2025 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Locations

180 E Main St
Ste 302
Smithtown, NY 11787
Phone (631) 265-6868

222 E Middle Country Rd
Ste 210
Smithtown, NY 11787
Phone (631) 265-6868

1400 Wantagh Ave
Ste L2
Wantagh, NY 11793
Phone (516) 559-0194

609 Route 109
Ste 1C
West Babylon, NY 11704
Phone (631) 321-7011

Organizations & group practices 3

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": "1312675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1265711386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MERRITTS RD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353216",
            "telephone_number": "516-668-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MERRITTS RD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353216",
            "telephone_number": "516-668-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESHLOCK",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PMHNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-07",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

Verify at the official NPI Registry.