Judith Wackman-Williams, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F402508-1 Issued in NY

Practice address

26 Court St Ste 808
Brooklyn, NY 11242-1108

Phone

(718) 522-3600

Fax

(718) 522-3667

NPI assigned

Jan 15, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: judith.wackman@bpmc.eclinicaldirectplus.com

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.

• Brooklyn Plaza Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1336113398

  Single Specialty

  Medicare reassignment NPD
• Whitman Ingersoll Farragut Health Center

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1619366978

  Single Specialty

  NPD
• East Point Medical PC

  • Family Medicine Physician
  • Maspeth, NY
  • NPI 1518571751

  Single Specialty

  NPD (past)
• Good Health Psychiatric Services PC

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1215213806

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1508330325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 SKIDMORE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365442",
            "telephone_number": "347-909-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 808",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421108",
            "telephone_number": "718-522-3600",
            "fax_number": "718-522-3667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1577 Fulton Street",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11213",
            "country_code": "US",
            "telephone_number": "718-522-3600",
            "fax_number": "728-522-3667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WACKMAN-WILLIAMS",
        "first_name": "JUDITH",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402508-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry C. Wachtel, M.D.
• Jessica Addi Wachtel, MD
• Paul Michael Wachtel
• Ruby Marcia Wachtel, NURSE PRACTITIONER
• Kimberly Wachter
• Aretha Wade, M.S.E.D
• Debra Wade, L.C.S.W.
• Isiah Wade
• Kim Wade, MSED
• Ryan Andrew Wade, CASAC

• Psychiatric/Mental Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.