Individual provider Active NPI

Naomi Noble

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1417721804
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405169 Issued in NY
Practice address
1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone
(718) 375-1200
NPI assigned
Nov 7, 2023
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ14916000 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405169 NY Primary

Addresses

Primary practice location

1623 Kings Hwy
Brooklyn, NY 11229-1209

Mailing address

1623 Kings Hwy
Brooklyn, NY 11229-1209

Other practice location 1

1060 Main St
River Edge, NJ 07661-2591
Phone (917) 540-6284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240215002960 NJ Practitioner - Nurse Practitioner 5991149114 Reassigns benefits to 1 organization
I20240829001195 NY Practitioner - Nurse Practitioner 5991149114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone 9292737601426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ14916000NJMDPsychiatric/Mental Health Nurse Practitioner
405169NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Aug 9, 2024 Accepting new patients
Ocd Psychiatry Current Accepting new patients
Tenafly Psychiatric Associates, L.L.C. CurrentSince Feb 1, 2024 Accepting new patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Aug 9, 2024 Accepting new patients

Locations

2 Dean Dr
Fl 1
Tenafly, NJ 07670
Phone (201) 568-8288

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1417721804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291209",
            "telephone_number": "718-375-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1060 Main St",
            "address_purpose": "LOCATION",
            "city": "River Edge",
            "state": "NJ",
            "postal_code": "076612591",
            "country_code": "US",
            "telephone_number": "917-540-6284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "NAOMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14916000",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.