Individual provider Active NPI

Dawn R Michael

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1275143554
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402320 Issued in NY
Practice address
300 W 72ND St Apt 1D
New York, NY 10023-2661
Phone
(631) 949-1878
NPI assigned
Aug 3, 2020
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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 402320 NY Primary

Addresses

Primary practice location

300 W 72ND St Apt 1D
New York, NY 10023-2661

Mailing address

30 Washington Ave
Mastic Beach, NY 11951-1901
Phone (631) 949-1878

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
I20200925001332 NY Practitioner - Nurse Practitioner 2466871355 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Care Physicians of Ny PLLCGroup PAC ID 3072933738, 8 clinicians

Practice addresses (Care Compare)

100 Southern Blvd
Nesconset, NY 11767-1749
Phone (631) 361-8800

378 Syosset Woodbury Rd
Woodbury, NY 11797-1200
Phone (631) 949-1878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
402320NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dawn Michael Nurse Practitioner in Psychiatry PC Psychiatric/Mental Health CurrentSince Dec 1, 2024 Accepting new patients
Care Physicians of Ny, PLLC CurrentSince Nov 1, 2023 Accepting new patients
Psychiatric Care Medical PLLC CurrentSince Aug 8, 2020 Accepting new patients
New York Neuromodulation Medical PLLC Past Accepting new patients

Locations

3155 Grace Ave
Bronx, NY 10469
Phone (718) 304-2866

801 Gazzola Dr
East Patchogue, NY 11772
Phone (631) 447-8800

5 Brewster St
Glen Cove, NY 11542
Phone (516) 674-4514

16411 Chapin Pkwy
#1
Jamaica, NY 11432
Phone (718) 298-7800

3115 Horseblock Rd
Medford, NY 11763
Phone (631) 730-3000

100 Southern Blvd
Nesconset, NY 11767
Phone (631) 361-8800

300 W 72nd St
Apt 1D
New York, NY 10023
Phone (212) 362-4331

150 Eileen Way
Unit 1
Syosset, NY 11791
Phone (516) 855-5255

378 Syosset Woodbury Rd
Woodbury, NY 11797
Phone (516) 622-7784

121 Franklin Pl
Woodmere, NY 11598
Phone (516) 374-9300

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1275143554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WASHINGTON AVE",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119511901",
            "telephone_number": "631-949-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 72ND ST APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232661",
            "telephone_number": "631-949-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "DAWN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.