Individual provider Active NPI

Tatyana Goykhberg, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Massapequa, NY
National Provider Identifier
1326699679
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402843 Issued in NY
Practice address
4190 Sunrise Highway
Suite a
Massapequa, NY 11758
Phone
(516) 765-7799
Fax
(334) 212-0233
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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 402843 NY Primary

Addresses

Primary practice location

4190 Sunrise Highway
Suite a
Massapequa, NY 11758

Mailing address

4190 Sunrise Highway
Suite a
Massapequa, NY 11758
Phone (516) 765-7799

Other identifiers 1

IdentifierTypeStateIssuer
402843OtherNYSTATE LICENSE

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
I20200123000094 NY Practitioner - Nurse Practitioner 8921433897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3330 Park Ave
Wantagh, NY 11793-3719
Phone (347) 741-9301

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore NP Psychiatry, PLLC Psychiatric/Mental Health CurrentSince Nov 19, 2023 Accepting new patients
Ariana Lombardo, LMFT Inc PastSince Jan 19, 2020 Accepting new patients

Locations

3330 Park Ave
Ste 9
Wantagh, NY 11793
Phone (347) 741-9301

Organizations & group practices 2

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": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1326699679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 SUNRISE HIGHWAY",
            "address_2": "SUITE A",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-765-7799",
            "fax_number": "334-212-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 SUNRISE HIGHWAY",
            "address_2": "SUITE A",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-765-7799",
            "fax_number": "334-212-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOYKHBERG",
        "first_name": "TATYANA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "402843",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.