Individual provider Active NPI

Lisa Palkert-Dawes, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1609399120
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402213 Issued in NY
Practice address
1020 Vestal Pkwy E
Vestal, NY 13850-1748
Phone
(607) 444-6868
Fax
(607) 444-8618
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 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 402213 NY Primary

Addresses

Primary practice location

1020 Vestal Pkwy E
Vestal, NY 13850-1748

Mailing address

1020 Vestal Pkwy E
Vestal, NY 13850-1748
Phone (607) 444-6868

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
I20171011001121 NY Practitioner - Nurse Practitioner 3375818743 Reassigns benefits to 4 organizations

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
Neurosciences Healthcare Medicine, PC 22 clinicians

Practice addresses (Care Compare)

1020 Vestal Pkwy E
Vestal, NY 13850-1748
Phone (607) 444-6868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
402213NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Sep 5, 2017 Accepting new patients
Rd Medical Professional Services PC CurrentSince Nov 20, 2022 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Sep 5, 2017 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

59 River St
Sidney, NY 13838
Phone (607) 531-8022

39 Pearl St W
Sidney, NY 13838
Phone (607) 561-2021

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

130 North St
Walton, NY 13856
Phone (607) 865-6541

Organizations & group practices 5

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": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1609399120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501748",
            "telephone_number": "607-444-6868",
            "fax_number": "607-444-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501748",
            "telephone_number": "607-444-6868",
            "fax_number": "607-444-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALKERT-DAWES",
        "first_name": "LISA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.