Individual provider Active NPI

Iselande Desyr, DNP PMHNP-BC FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Stratford, CT
National Provider Identifier
1487190278
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6914 Issued in CT
Practice address
2875 Main Street
Suite 2a
Stratford, CT 06614-4979
Phone
(929) 447-2053
NPI assigned
Jan 17, 2017
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6914 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 6914 CT Primary

Addresses

Primary practice location

2875 Main Street
Suite 2a
Stratford, CT 06614-4979

Mailing address

2875 Main St
Ste 2a
Stratford, CT 06614-4979
Phone (929) 447-2053

Other identifiers 1

IdentifierTypeStateIssuer
6914MedicaidCT

Other names 1

  • Dr. Iselande Desyr Professional name

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
6914CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Outcomes, LLC Past Accepting new patients
Home Sweet Home Nursing Agency LLC Past Accepting new patients

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, 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": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1487190278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 MAIN ST",
            "address_2": "STE 2A",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144979",
            "telephone_number": "929-447-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 MAIN STREET",
            "address_2": "SUITE 2A",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144979",
            "telephone_number": "929-447-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESYR",
        "first_name": "ISELANDE",
        "name_prefix": "Dr.",
        "credential": "DNP  PMHNP-BC FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6914",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "6914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6914",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISELANDE",
            "last_name": "DESYR",
            "prefix": "DR.",
            "credential": "DNP APRN PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Stratford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.