Individual provider Active NPI

Connor R Cottrell

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1386508216
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F408197 Issued in NY
Practice address
306 E 78TH St Apt 5B
New York, NY 10075-2267
Phone
(585) 944-0957
NPI assigned
Dec 15, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 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 PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X F408197 NY Primary

Addresses

Primary practice location

306 E 78TH St Apt 5B
New York, NY 10075-2267

Mailing address

306 E 78TH St Apt 5B
New York, NY 10075-2267
Phone (585) 944-0957

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
I20260527003176 NY Practitioner - Nurse Practitioner 9537639968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1590 Wellington Ave
Savannah, NY 13146-3160

165 Passaic Ave
Suite 200
Fairfield, NJ 07004-3564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F408197NYMDPsychiatric/Mental Health Nurse Practitioner

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": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1386508216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E 78TH ST APT 5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100752267",
            "telephone_number": "585-944-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E 78TH ST APT 5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100752267",
            "telephone_number": "585-944-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTRELL",
        "first_name": "CONNOR",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-15",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F408197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.