Individual provider Active NPI

Charlene T Maher, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Medford, NY
National Provider Identifier
1598898587
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400098 Issued in NY
Practice address
1727 N Ocean Ave
Medford, NY 11763-2649
Phone
(631) 654-1919
NPI assigned
Mar 13, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 F400098 NY Primary

Addresses

Primary practice location

1727 N Ocean Ave
Medford, NY 11763-2649

Mailing address

84 Camille LN
East Patchogue, NY 11772-4555
Phone (631) 654-1919

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
I20070423000425 NY Practitioner - Nurse Practitioner 1759486574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York Downstate Medical Center, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1727 N Ocean Ave
Medford, NY 11763-2649
Phone (631) 654-1919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F400098NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Diocese of Rockville Centre Current Accepting new patients
Catholic Charities of the Diocese of Rockville Centre CurrentSince Feb 15, 2007 Accepting new patients
Catholic Charities of the Diocese of Rockville Centre CurrentSince Feb 15, 2007 Accepting new patients
Association for Mental Health and Wellness Inc PastSince Apr 1, 2006 Accepting new patients

Locations

333 N Main St
Freeport, NY 11520
Phone (516) 623-3322

90 Cherry Ln
Hicksville, NY 11801
Phone (516) 733-7040

1727 N Ocean Ave
Medford, NY 11763
Phone (631) 684-1919

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/77c2b089-5ae8-473f-98a4-de9173e168aa/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1598898587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 CAMILLE LN",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724555",
            "telephone_number": "631-654-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 N OCEAN AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632649",
            "telephone_number": "631-654-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "CHARLENE",
        "middle_name": "T",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.