Individual provider Active NPI

Angela Heffner, CRNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Manhasset, NY
National Provider Identifier
1447444542
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP027491 Issued in PA
Practice address
1457 Northern Blvd
Manhasset, NY 11030-3003
Phone
(516) 738-5600
Fax
(516) 869-0650
NPI assigned
Aug 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 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 406041 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP027491 PA Primary

Addresses

Primary practice location

1457 Northern Blvd
Manhasset, NY 11030-3003

Mailing address

436 Park LN
State College, PA 16803-1441
Phone (814) 954-2544

Other practice location 1

330 Innovation Blvd Ste 205
State College, PA 16803-6611
Phone (814) 954-2544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
406041NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PM Pediatric Care - New York, P.C. CurrentSince Dec 8, 2024 Accepting new patients
PM Pediatrics BH II, P.C. Past Accepting new patients

Locations

1457 Northern Blvd
Manhasset, NY 11030
Phone (516) 520-5437

1 Hollow Ln
Ste 301
New Hyde Park, NY 11042
Phone (516) 207-7851

Organizations & group practices 2

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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1447444542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 PARK LN",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031441",
            "telephone_number": "814-954-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 NORTHERN BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303003",
            "telephone_number": "516-738-5600",
            "fax_number": "516-869-0650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Innovation Blvd Ste 205",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168036611",
            "country_code": "US",
            "telephone_number": "814-954-2544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEFFNER",
        "first_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "CRNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406041",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP027491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.