Individual provider Active NPI

Kelsey Sobczak, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1497624977
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
406435 Issued in NY
Practice address
80 5TH Ave Ofc 903-10
New York, NY 10011-8002
Phone
(347) 707-7735
NPI assigned
Nov 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 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 406435 NY Primary

Addresses

Primary practice location

80 5TH Ave Ofc 903-10
New York, NY 10011-8002

Mailing address

80 5TH Ave # 903-10
New York, NY 10011-8002
Phone (347) 707-7735

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
I20260303000388 NY Practitioner - Nurse Practitioner 8426530288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

181 Charlescrest CT
West Seneca, NY 14224-3809

618 Ave Jose Efron
Unit 649
Dorado, PR 00646

80 5TH Ave
Suite 903 10
New York, NY 10011-8020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
406435NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orenda Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jan 20, 2026 Accepting new patients

Locations

80 5th Ave
Ste 90310
New York, NY 10011

80 5th Ave
#90310
New York, NY 10011

80 5th Ave
New York, NY 10011
Phone (646) 460-0097

80 5th Ave
Ofc 90310
New York, NY 10011
Phone (347) 886-1088

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": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1497624977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 5TH AVE # 903-10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118002",
            "telephone_number": "347-707-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 5TH AVE OFC 903-10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118002",
            "telephone_number": "347-707-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBCZAK",
        "first_name": "KELSEY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.