Individual provider Active NPI

Desmonique Chanti Homs

  • Psychiatric/Mental Health Nurse Practitioner
  • Amsterdam, NY
National Provider Identifier
1508419102
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402756 Issued in NY
Practice address
4988 State Highway 30
Amsterdam, NY 12010-7520
Phone
(518) 421-0286
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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 402756 NY Primary

Addresses

Primary practice location

4988 State Highway 30
Amsterdam, NY 12010-7520

Mailing address

4988 State Highway 30
Amsterdam, NY 12010-7520
Phone (518) 421-0286

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address desmonique.homs@ascension.org

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
I20191217001924 NY Practitioner - Nurse Practitioner 2264866748 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
402756NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Marys Healthcare CurrentSince Oct 27, 2019 Accepting new patients
St. Mary'S Healthcare CurrentSince Oct 27, 2019 Accepting new patients

Locations

4988 State Highway 30
Amsterdam, NY 12010
Phone (518) 842-3100

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

Organizations & group practices 2

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": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1508419102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4988 STATE HIGHWAY 30",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-421-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4988 STATE HIGHWAY 30",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-421-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMS",
        "first_name": "DESMONIQUE",
        "middle_name": "CHANTI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "desmonique.homs@ascension.org",
            "affiliation": "N",
            "address_1": "4988 State Highway 30",
            "city": "Amsterdam",
            "state": "NY",
            "country_code": "US",
            "postal_code": "120107520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

Verify at the official NPI Registry.