Individual provider Active NPI

Walter Dore, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Yonkers, NY
National Provider Identifier
1497444582
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403838 Issued in NY
Practice address
45 Ludlow St Ste 402
Yonkers, NY 10705-1949
Phone
(347) 667-7924
Fax
(332) 262-2396
NPI assigned
May 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 1058299 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403838 NY Primary

Addresses

Primary practice location

45 Ludlow St Ste 402
Yonkers, NY 10705-1949

Mailing address

3737 Dacoma St
Houston, TX 77092-8905
Phone (346) 479-5556

Other practice location 1

3737 Dacoma St
Houston, TX 77092-8905
Phone (346) 479-5556

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
I20250304003445 NY Practitioner - Nurse Practitioner 3577084797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sehwan Medical Care PLLCGroup PAC ID 8022468875, 56 clinicians

Practice addresses (Care Compare)

45 Ludlow St
Suite 402
Yonkers, NY 10705-1949
Phone (914) 570-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1058299TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sehwan Medical Care PLLC CurrentSince Dec 29, 2024 Accepting new patients

Locations

831 Bedford Ave
Brooklyn, NY 11205

45 Ludlow St
Ste 402
Yonkers, NY 10705
Phone (914) 570-9000

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": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1497444582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 DACOMA ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770928905",
            "telephone_number": "346-479-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LUDLOW ST STE 402",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107051949",
            "telephone_number": "347-667-7924",
            "fax_number": "332-262-2396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3737 Dacoma St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770928905",
            "country_code": "US",
            "telephone_number": "346-479-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORE",
        "first_name": "WALTER",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-03",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1058299",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.