Individual provider Active NPI

Patrick F Lancaster, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Medford, NY
National Provider Identifier
1518376169
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405650-01 Issued in NY
Practice address
164 Cherry LN
Medford, NY 11763-4022
Phone
(631) 566-7829
NPI assigned
Aug 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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 F405650-01 NY Primary

Addresses

Primary practice location

164 Cherry LN
Medford, NY 11763-4022

Mailing address

164 Cherry LN
Medford, NY 11763-4022
Phone (631) 566-7829

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
I20240715000954 NY Practitioner - Nurse Practitioner 2567907538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2090 Adam Clayton Powell Jr Blvd
FL 4
New York, NY 10027-4941
Phone (212) 553-6751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F405650-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Alternative Sentencing and Employment Services CurrentSince May 23, 2024 Accepting new patients

Locations

151 Lawrence St
Fl 3
Brooklyn, NY 11201
Phone (212) 553-6300

2090 Adam Clayton Powell Jr Blvd
Fl 4
New York, NY 10027
Phone (212) 553-6708

Organizations & group practices 1

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": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1518376169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 CHERRY LN",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634022",
            "telephone_number": "631-566-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 CHERRY LN",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634022",
            "telephone_number": "631-566-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "PATRICK",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-07",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405650-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.