Active NPI
Gary Carlisle
- Psychiatric/Mental Health Nurse Practitioner
- New York, NY
National Provider Identifier
1417368838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- F401463-1
- Practice address
- 150 E 58TH St
25TH FL
New York, NY 10155-0002 - Phone
- (212) 223-2920
- Fax
- (212) 223-2390
- NPI assigned
- May 20, 2014
- Last updated
- May 21, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F401463-1 | NY | Primary |
Addresses
Primary practice location
150 E 58TH St
25TH FL
New York, NY 10155-0002
Mailing address
150 E 58TH St
25TH FL
New York, NY 10155-0002
Phone (212) 223-2920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 17, 2025 through Dec 17, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F401463-1 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400630400000",
"number": "1417368838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 E 58TH ST",
"address_2": "25TH FL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101550002",
"telephone_number": "212-223-2920",
"fax_number": "212-223-2390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 E 58TH ST",
"address_2": "25TH FL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101550002",
"telephone_number": "212-223-2920",
"fax_number": "212-223-2390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLISLE",
"first_name": "GARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-20",
"last_updated": "2014-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "F401463-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.