Brian Yudhistira, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403375 Issued in NY

Practice address

80 5TH Ave
New York, NY 10011-8002

Phone

(347) 707-7735

Fax

(718) 750-9135

NPI assigned

Mar 21, 2021

Last updated

Jul 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthy Minds Wny L.L.C

  • Psychiatric/Mental Health Nurse Practitioner
  • Buffalo, NY
  • NPI 1487377032
  NPD Authorized official
• Orenda Psychiatry PLLC

  dba Orenda Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1528663945
  NPD

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1508442567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WAVERLY AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171056",
            "telephone_number": "347-229-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118002",
            "telephone_number": "347-707-7735",
            "fax_number": "718-750-9135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "254 Franklin St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142021932",
            "country_code": "US",
            "telephone_number": "716-852-1117",
            "fax_number": "716-852-1110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Waverly Ave",
            "address_purpose": "LOCATION",
            "city": "Kenmore",
            "state": "NY",
            "postal_code": "142171056",
            "country_code": "US",
            "telephone_number": "347-229-3939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3176 Abbott Rd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "141271069",
            "country_code": "US",
            "telephone_number": "716-391-5700",
            "fax_number": "716-240-9878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUDHISTIRA",
        "first_name": "BRIAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-21",
        "last_updated": "2024-07-06",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403375",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "752585",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ziyi Yuan, RD
• Hanna Yudchyts
• Alyssa Yudell, OTR/L
• Daniela Yudell
• Ian M Yudelman
• Matias Yudi
• Marina Yuditskaya, NP
• Elaine Yudkovitz, PHD,LCSW
• Francine S Yudkowitz, M.D.
• Audrey Jane Yue, OD

• Psychiatric/Mental Health Nurse Practitioner in New York, NY
• Providers in New York, 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 Jul 6, 2024; 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.