Individual provider Active NPI

William Nicholas Van Horn, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lyons, NY
National Provider Identifier
1497612121
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
407784 Issued in NY
Practice address
1519 Nye Rd
Lyons, NY 14489-9133
Phone
(315) 946-5722
NPI assigned
Jan 6, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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 407784 NY Primary

Addresses

Primary practice location

1519 Nye Rd
Lyons, NY 14489-9133

Mailing address

297 Valley Rd
Rochester, NY 14618-2511
Phone (843) 315-5094

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
I20260504007737 NY Practitioner - Nurse Practitioner 0244708626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of WayneGroup PAC ID 8921919994, 21 clinicians

Practice addresses (Care Compare)

1519 Nye Rd
Lyons, NY 14489-9112

1519 Nye Rd
Lyons, NY 14489-9133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
407784NYMDPsychiatric/Mental Health Nurse Practitioner

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": "1767657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1497612121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 VALLEY RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182511",
            "telephone_number": "843-315-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 NYE RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899133",
            "telephone_number": "315-946-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HORN",
        "first_name": "WILLIAM",
        "middle_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-06",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, NY

Sources for this page

Verify at the official NPI Registry.