Individual provider Active NPI

Katie Leigh Lyver, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bay Shore, NY
National Provider Identifier
1336922327
Registry record updated Apr 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405158-01 Issued in NY
Practice address
21 4TH Ave
Bay Shore, NY 11706-7908
Phone
(631) 665-6707
NPI assigned
Aug 15, 2023
Last updated
Apr 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 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 F405158-01 NY Primary

Addresses

Primary practice location

21 4TH Ave
Bay Shore, NY 11706-7908

Mailing address

205 Arnold Ave
West Babylon, NY 11704-7211
Phone (631) 671-5705

Other practice location 1

205 Arnold Ave
West Babylon, NY 11704-7211
Phone (631) 671-5705

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
I20240327002462 NY Practitioner - Nurse Practitioner 9638516362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

21 4TH Ave
Bay Shore, NY 11706-7908
Phone (631) 665-6707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F405158-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Diocese of Rockville Centre Current Accepting new patients
Catholic Charities of the Diocese of Rockville Centre CurrentSince Feb 7, 2024 Accepting new patients
Catholic Charities of the Diocese of Rockville Centre CurrentSince Feb 7, 2024 Accepting new patients
Catholic Charities of the Diocese of Rockville Centre Past Accepting new patients

Locations

21 4th Ave
Bay Shore, NY 11706
Phone (631) 665-6707

31 E Montauk Hwy
Hampton Bays, NY 11946
Phone (516) 733-7040

90 Cherry Ln
Hicksville, NY 11801
Phone (516) 733-7040

1727 N Ocean Ave
Medford, NY 11763
Phone (631) 684-1919

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

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776556800000",
    "number": "1336922327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ARNOLD AVE",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117047211",
            "telephone_number": "631-671-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 4TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067908",
            "telephone_number": "631-665-6707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Arnold Ave",
            "address_purpose": "LOCATION",
            "city": "West Babylon",
            "state": "NY",
            "postal_code": "117047211",
            "country_code": "US",
            "telephone_number": "631-671-5705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYVER",
        "first_name": "KATIE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405158-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.