NPIMap

Organization Active NPI

Mindful Med Management Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Port Jefferson, NY
National Provider Identifier
1366242273
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDFUL MED MANAGEMENT INC
Practice address
100 Mariners Way
Port Jefferson, NY 11777-1848
Phone
(631) 991-0052
NPI assigned
Mar 18, 2025
Last updated
Apr 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
April Lee, NPNPI 1972135481
Title
Owner
Phone
(631) 509-7488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

100 Mariners Way
Port Jefferson, NY 11777-1848

Mailing address

100 Mariners Way
Port Jefferson, NY 11777-1848
Phone (631) 509-7488

Other practice location 1

475 E Main St
Patchogue, NY 11772-3121
Phone (631) 413-1477

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1366242273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARINERS WAY",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771848",
            "telephone_number": "631-509-7488",
            "fax_number": "631-778-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARINERS WAY",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771848",
            "telephone_number": "631-991-0052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 E Main St",
            "address_purpose": "LOCATION",
            "city": "Patchogue",
            "state": "NY",
            "postal_code": "117723121",
            "country_code": "US",
            "telephone_number": "631-413-1477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL MED MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-509-7488",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.