Individual provider Active NPI

Joan Dasilva

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1386334647
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405185-01 Issued in NY
Practice address
104 W 40TH St Ste 416
New York, NY 10018-3617
Phone
(212) 369-6757
NPI assigned
May 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 683621-01 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F405185-01 NY Primary

Addresses

Primary practice location

104 W 40TH St Ste 416
New York, NY 10018-3617

Mailing address

104 W 40TH St Ste 416
New York, NY 10018-3617

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
I20240416000337 NY Practitioner - Nurse Practitioner 7517306194 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
683621-01NYMDRegistered Nurse
F405185-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bleuler Psychotherapy Center, Inc. CurrentSince Jul 11, 2024 Accepting new patients
El Regreso, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Sr Medical Services PLLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

141 S 3rd St
Brooklyn, NY 11211
Phone (718) 384-6400

189 S 2nd St
Ste 191
Brooklyn, NY 11211

10470 Queens Blvd
Ste 200
Forest Hills, NY 11375
Phone (866) 404-6913

3764 72nd St
Jackson Hts, NY 11372
Phone (718) 335-3434

1400 Old Country Rd
Ste 200A
Westbury, NY 11590
Phone (833) 350-8255

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

Organizations & group practices 3

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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1386334647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 40TH ST STE 416",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 40TH ST STE 416",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183617",
            "telephone_number": "212-369-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASILVA",
        "first_name": "JOAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "683621-01",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405185-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.