Mukta Gautam-Dhakal

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024177376 Issued in VA

Practice address

12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463

Phone

(703) 596-4796

NPI assigned

Feb 27, 2018

Last updated

Feb 9, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, DC, VA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

My Psychiatrist, LLCGroup PAC ID 5597898981, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mukta.gautam-dhakal.1@18773.direct.athenahealth.com

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.

• My Psychiatrist LLC

  dba My Psychiatrist PLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Reston, VA
  • NPI 1295048684

  DC

  Medicare reassignment Care Compare group NPD
• Arman C. Moshyedi, MD, PLLC

  • Psychiatry Physician
  • McLean, VA
  • NPI 1366005183
  Medicare reassignment NPD
• Jehdhun

  • Cardiovascular Disease Physician
  • Elizabeth, NJ
  • NPI 1053604520
  NPD
• Greenbrook TMS Roanoke

  • Psychiatry Physician
  • Roanoke, VA
  • NPI 1427561059
  NPD (past)

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1275034837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 WILLIAMSON ST APT C5",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023663",
            "telephone_number": "201-315-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "703-596-4796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Williamson St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072023671",
            "country_code": "US",
            "telephone_number": "732-491-9597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUTAM-DHAKAL",
        "first_name": "MUKTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00806800",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024177376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Garfield
• Thaddeus Markham Garland, M.D.
• Melaina Neyer Garrison, LMFT
• Roberta Lee Gartside, M.D.
• Terry A. Garvert, MD
• Gazelle Clinical System, Inc. (Gazelle Clinical Research)
• Ruth Gebremicael
• Generations Family Medicine PC (Generations Family Practice)
• Genlabx LLC (GenLabX)
• Paige Gentile, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Reston, VA
• Providers in Reston, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.