Catherine Poulos, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F-401489 Issued in NY

Practice address

332 W Montauk Hwy Ste 5
Hampton Bays, NY 11946-3551

Phone

(631) 495-3300

Fax

(631) 822-2833

NPI assigned

Oct 16, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673136000000",
    "number": "1396997672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 W MONTAUK HWY STE 5",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119463551",
            "telephone_number": "631-495-3300",
            "fax_number": "631-822-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 W MONTAUK HWY STE 5",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119463551",
            "telephone_number": "631-495-3300",
            "fax_number": "631-822-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2023-01-08",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F-401489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0379L760",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa R Pfleger, OPTICIAN
• Eileen Elizabeth Philbin, R.N.
• Althea Elizabeth Phillips, RN/BSN
• Gerard Harry Piering Jr., DC
• Olivia Pimenta
• Nadyne Vanessa Pressley, RN
• Prime Care Medical of Long Island, PC
• Prime Path Care LLC
• Marc Puchir, D.O.
• Maura B Quealy, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Hampton Bays, NY
• Providers in Hampton Bays, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.