Individual provider Active NPI

Naomi Fisher, DNP-PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Carmel, NY
National Provider Identifier
1306484894
Registry record updated Dec 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402887 Issued in NY
Practice address
667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455
Phone
(845) 279-5908
NPI assigned
Dec 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2019

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 8612 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402887 NY Primary

Addresses

Primary practice location

667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455

Mailing address

83 West St Apt 10
New Milford, CT 06776-3556
Phone (203) 241-6063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200416002088 CT Practitioner - Nurse Practitioner 5294162392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8612CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Health Psych PC Psychiatric/Mental Health CurrentSince Jun 1, 2021 Accepting new patients

Locations

14 Westport Ave
Norwalk, CT 06851
Phone (203) 497-3867

240 Indian River Rd
Ste C
Orange, CT 06477
Phone (203) 497-3867

240 Indian River Rd
Ste C7
Orange, CT 06477
Phone (203) 497-3867

Organizations & group practices 1

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": "1576368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576368000000",
    "number": "1306484894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 WEST ST APT 10",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763556",
            "telephone_number": "203-241-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 STONELEIGH AVE STE 202",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122455",
            "telephone_number": "845-279-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "NAOMI",
        "credential": "DNP-PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-15",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "8612",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, NY

Sources for this page

Verify at the official NPI Registry.