NPIMap

Organization Active NPI

Premier Psychiatric Consultants LLC

  • Adult Mental Health Clinic/Center
  • West New York, NJ
National Provider Identifier
1508182072
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
25MA0821070 Issued in NJ
Legal business name
PREMIER PSYCHIATRIC CONSULTANTS LLC
Practice address
6000 Washington St
West New York, NJ 07093-1420
Phone
(201) 864-4897
Fax
(201) 864-4871
NPI assigned
Apr 8, 2010
Last updated
Dec 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Dr. Yissell DelvalleNPI 1750585709
Title
President
Phone
(917) 345-4273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 25MA0821070 NJ Primary

Addresses

Primary practice location

6000 Washington St
West New York, NJ 07093-1420

Mailing address

6000 Washington St
West New York, NJ 07093-1420
Phone (201) 864-4897

Other identifiers 1

IdentifierTypeStateIssuer
1750585709OtherNJNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100604000555 NJ Part B Supplier - Clinic/Group Practice 7315077120 Receives reassigned benefits from 10 practitioners
Practice locations: Hackensack, NJ; West New York, NJ

National Provider Directory

National Provider Directory

Locations

14 N Dean St
Englewood, NJ 07631
Phone (201) 646-8015

235 Prospect Ave
Ste Lf
Hackensack, NJ 07601
Phone (201) 489-0099

171 E Ridgewood Ave
Ste 203
Ridgewood, NJ 07450
Phone (201) 470-4006

51 Upper Montclair Plz
Ste 26
Upper Montclair, NJ 07043
Phone (201) 470-4006

82 Elm St
Westfield, NJ 07090
Phone (201) 470-4006

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1508182072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 WASHINGTON ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931420",
            "telephone_number": "201-864-4897",
            "fax_number": "201-864-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 WASHINGTON ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931420",
            "telephone_number": "201-864-4897",
            "fax_number": "201-864-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PSYCHIATRIC CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "DELVALLE",
        "authorized_official_first_name": "YISSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-345-4273",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NJ",
            "license": "25MA0821070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750585709",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.