Individual provider Active NPI

Ashley Mathai

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1306330295
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402491 Issued in NY
Practice address
800 Poly PL
Brooklyn, NY 11209-7104
Phone
(718) 836-6600
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 685313 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402491 NY Primary

Addresses

Primary practice location

800 Poly PL
Brooklyn, NY 11209-7104

Mailing address

800 Poly PL
Brooklyn, NY 11209-7104

Other practice location 1

575 Madison Ave Fl 10
New York, NY 10022-2511
Phone (888) 220-6392

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
I20181030000530 NY Practitioner - Nurse Practitioner 9638422256 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
685313NYMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
402491NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Kingsbrook Medical Associates PC CurrentSince Aug 24, 2019 Accepting new patients
Sun River Health Inc. CurrentSince Mar 23, 2019 Accepting new patients
Kingsbrook Medical Associates, PC CurrentSince Aug 24, 2019 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

1110 Eastern Pkwy
Pier Toussaint
Brooklyn, NY 11213
Phone (718) 735-1900

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

57 Bay St
Staten Island, NY 10301
Phone (718) 226-3200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1306330295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 Madison Ave Fl 10",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100222511",
            "country_code": "US",
            "telephone_number": "888-220-6392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHAI",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NY",
            "license": "685313",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.