Individual provider Active NPI

David Valdecantos, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hauppauge, NY
National Provider Identifier
1497241632
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402455 Issued in NY
Practice address
90 Adams Ave
Hauppauge, NY 11788-3631
Phone
(631) 952-3333
NPI assigned
Jul 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402455 NY Primary

Addresses

Primary practice location

90 Adams Ave
Hauppauge, NY 11788-3631

Mailing address

90 Adams Ave
Hauppauge, NY 11788-3631
Phone (631) 952-3333

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190122003180 NY Practitioner - Nurse Practitioner 0042557563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Service League IncGroup PAC ID 4284524448, 47 clinicians

Practice addresses (Care Compare)

55 Horizon Dr
Huntington, NY 11743-4436
Phone (631) 369-2300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
402455NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service League, Inc. CurrentSince Nov 24, 2018 Accepting new patients

Locations

90 Adams Ave
Hauppauge, NY 11788
Phone (631) 392-0081

55 Horizon Dr
Huntington, NY 11743
Phone (631) 396-2300

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

Organizations & group practices 1

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": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1497241632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 ADAMS AVE",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883631",
            "telephone_number": "631-952-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 ADAMS AVE",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883631",
            "telephone_number": "631-952-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDECANTOS",
        "first_name": "DAVID",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

Verify at the official NPI Registry.