Individual provider Active NPI

Daniel Georges, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1508429341
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
407084 Issued in NY
Practice address
15015 109TH Rd
Jamaica, NY 11433-3108
Phone
(917) 600-3531
Fax
(888) 651-5187
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 766476 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 407084 NY Primary

Addresses

Primary practice location

15015 109TH Rd
Jamaica, NY 11433-3108

Mailing address

15015 109TH Rd
Jamaica, NY 11433-3108
Phone (626) 212-2175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
766476NYMDRegistered Nurse
407084NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1508429341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15015 109TH RD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114333108",
            "telephone_number": "626-212-2175",
            "fax_number": "888-651-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15015 109TH RD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114333108",
            "telephone_number": "917-600-3531",
            "fax_number": "888-651-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGES",
        "first_name": "DANIEL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "766476",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.