Individual provider Active NPI

Justin Joseph McEvoy, APRN PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Grove, NY
National Provider Identifier
1497588289
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
406085 Issued in NY
Practice address
928 Hawkins Ave
Lake Grove, NY 11755-1642
Phone
(631) 905-6774
NPI assigned
Aug 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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 406085 NY Primary

Addresses

Primary practice location

928 Hawkins Ave
Lake Grove, NY 11755-1642

Mailing address

928 Hawkins Ave
Lake Grove, NY 11755-1642
Phone (631) 905-6774

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
I20241022004002 NY Practitioner - Nurse Practitioner 1153853643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Empire NP Psychiatry PCGroup PAC ID 2668884321, 10 clinicians

Practice addresses (Care Compare)

100 N Village Ave
Suite 27
Rockville Centre, NY 11570-3712
Phone (516) 900-7646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empire NP Psychiatry PC Psychiatric/Mental Health CurrentSince Aug 30, 2024 Accepting new patients

Locations

100 N Village Ave
Ste 27
Rockville Ctr, NY 11570
Phone (516) 277-6121

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": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1497588289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 HAWKINS AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551642",
            "telephone_number": "631-905-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 HAWKINS AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551642",
            "telephone_number": "631-905-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEVOY",
        "first_name": "JUSTIN",
        "middle_name": "JOSEPH",
        "credential": "APRN PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

Verify at the official NPI Registry.