Individual provider Active NPI

Elisa M Mattei, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • South Setauket, NY
National Provider Identifier
1336550359
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F403765-01 Issued in NY
Practice address
3771 Nesconset Hwy Ste 107
South Setauket, NY 11720-1155
Phone
(631) 881-4569
Fax
(631) 944-8000
NPI assigned
May 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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 F403765-01 NY Primary

Addresses

Primary practice location

3771 Nesconset Hwy Ste 107
South Setauket, NY 11720-1155

Mailing address

3771 Nesconset Hwy Ste 107
South Setauket, NY 11720-1155
Phone (631) 881-4569

Other identifiers 1

IdentifierTypeStateIssuer
F403765-01MedicaidNY

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
I20250625001663 NY Practitioner - Nurse Practitioner 2062924046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dove Psychiatry- NP in Psychiatry, PLLCGroup PAC ID 1153833132, 2 clinicians

Practice addresses (Care Compare)

3771 Nesconset Hwy
Suite 107
South Setauket, NY 11720-1155
Phone (631) 881-4569

8 Manor Rd
Smithtown, NY 11787-2715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F403765-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dove Psychiatry- NP in Psychiatry, PLLC Psychiatric/Mental Health CurrentSince May 18, 2025 Accepting new patients

Locations

8 Manor Rd
Smithtown, NY 11787
Phone (631) 265-4670

3771 Nesconset Hwy
Ste 107
South Setauket, NY 11720
Phone (631) 250-4141

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1336550359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 NESCONSET HWY STE 107",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201155",
            "telephone_number": "631-881-4569",
            "fax_number": "631-944-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 NESCONSET HWY STE 107",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201155",
            "telephone_number": "631-881-4569",
            "fax_number": "631-944-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEI",
        "first_name": "ELISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403765-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F403765-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Setauket, NY

Sources for this page

Verify at the official NPI Registry.