Individual provider Active NPI

Julia Dorber, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1306687314
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405939 Issued in NY
Practice address
1500 Vestal Pkwy E
Vestal, NY 13850-1830
Phone
(604) 786-0435
NPI assigned
Jun 4, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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 405939 NY Primary

Addresses

Primary practice location

1500 Vestal Pkwy E
Vestal, NY 13850-1830

Mailing address

1500 Vestal Pkwy E
Vestal, NY 13850-1830
Phone (604) 786-0435

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
I20240724002789 NY Practitioner - Nurse Practitioner 9537605753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Tier Psychiatry PLLCGroup PAC ID 4587006697, 7 clinicians

Practice addresses (Care Compare)

1500 Vestal Pkwy E
Suite 102
Vestal, NY 13850-1831
Phone (607) 307-5015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
405939NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Tier Psychiatry PLLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

1500 Vestal Pkwy E
Ste 102
Vestal, NY 13850
Phone (607) 307-5015

3439 Vestal Pkwy E
#2
Vestal, NY 13850

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1306687314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501830",
            "telephone_number": "604-786-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501830",
            "telephone_number": "604-786-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORBER",
        "first_name": "JULIA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.