Tamisha Kelly, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403636 Issued in NY

Practice address

873 Balfour St
Valley Stream, NY 11580-1524

Phone

(917) 449-7395

NPI assigned

Apr 14, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

State University of New York at Stony Brook, School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychiatric Nurse Practitioner PCGroup PAC ID 6901221795, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Psychiatric Nurse Practitioner P.C

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1518595727
  Medicare reassignment Care Compare group NPD
• Sr Medical Services PLLC

  • Psychiatry Physician
  • Westbury, NY
  • NPI 1063119543
  Medicare reassignment NPD
• Inner Balance NP in Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albany, NY
  • NPI 1720966708
  NPD Authorized official

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1487073821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "873 BALFOUR ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801524",
            "telephone_number": "917-449-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 BALFOUR ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801524",
            "telephone_number": "917-449-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TAMISHA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "655257-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed Sohaib Kazim, PHARMACIST
• Kekeli Counseling Services LLC
• Anne Keleman, M.S.
• Charles Kellerman, LMSW
• Geraldine M Kelly, NURSE PRACTITIONER
• Florence Kema-Akpala, RN
• Jessica Ann Kennedy, D.C.
• Ruby Puneet Kesar, MD
• Khan Korh LLC
• Ali Khan

• Psychiatric/Mental Health Nurse Practitioner in Valley Stream, NY
• Providers in Valley Stream, 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 Nov 10, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.