Individual provider Active NPI

Quilon Wise, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1346081478
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405937 Issued in NY
Practice address
274 Madison Ave RM 1501
New York, NY 10016-0701
Phone
(212) 203-1773
Fax
(646) 665-4427
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 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 405937 NY Primary

Addresses

Primary practice location

274 Madison Ave RM 1501
New York, NY 10016-0701

Mailing address

274 Madison Ave RM 1501
New York, NY 10016-0701
Phone (212) 203-1773

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
I20240918003623 NY Practitioner - Nurse Practitioner 2567903438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rivia Medical PLLCGroup PAC ID 4880009943, 67 clinicians

Practice addresses (Care Compare)

350 E Ave
Suite 203
Rochester, NY 14604-2604
Phone (212) 203-1773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rivia Medical PLLC CurrentSince Jul 13, 2025 Accepting new patients
Rivia Medical PLLC Psychiatric/Mental Health CurrentSince May 13, 2025 Accepting new patients
Behavioral Health Services North, Inc. CurrentSince Aug 19, 2024 Accepting new patients
Behavioral Health Services North, Inc. CurrentSince Aug 19, 2024 Accepting new patients

Locations

401 New Karner Rd
Ste 301
Albany, NY 12205
Phone (212) 203-1173

2155 State Route 22B
Morrisonville, NY 12962
Phone (518) 562-3847

274 Madison Ave
Rm 1501
New York, NY 10016
Phone (212) 202-1773

22 US Oval
Ste 218
Plattsburgh, NY 12903
Phone (518) 534-9666

25 Willowbrook Rd
Queensbury, NY 12804
Phone (518) 793-9156

350 East Ave
Ste 203
Rochester, NY 14604

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1346081478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 MADISON AVE RM 1501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160701",
            "telephone_number": "212-203-1773",
            "fax_number": "646-665-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 MADISON AVE RM 1501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160701",
            "telephone_number": "212-203-1773",
            "fax_number": "646-665-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "QUILON",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.