Individual provider Active NPI

Christine Chollak, MSN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1619519717
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402855 Issued in NY
Practice address
1577 Fulton St
Brooklyn, NY 11213
Phone
(718) 307-1577
NPI assigned
Oct 10, 2019
Last updated
Oct 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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 402855 NY Primary

Addresses

Primary practice location

1577 Fulton St
Brooklyn, NY 11213

Mailing address

1577 Fulton St
Brooklyn, NY 11213

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
I20191122001122 NY Practitioner - Nurse Practitioner 2365874781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Health Psychiatric Services PCGroup PAC ID 2365789674, 26 clinicians

Practice addresses (Care Compare)

6219 5TH Ave
Brooklyn, NY 11220-4611
Phone (718) 522-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Psychiatric Services PC CurrentSince Oct 4, 2019 Accepting new patients
Rudoy Medical PC CurrentSince Oct 4, 2019 Accepting new patients
East Point Medical PC Psychiatric/Mental Health CurrentSince Jan 1, 2021 Accepting new patients

Locations

1523 Voorhies Ave
Brooklyn, NY 11235
Phone (718) 524-3600

1577 Fulton St
Brooklyn, NY 11213
Phone (347) 915-1411

26 Court St
Ste 1510
Brooklyn, NY 11242
Phone (718) 522-3600

26 Court St
Ste 808
Brooklyn, NY 11242
Phone (718) 307-1577

6219 5th Ave
Brooklyn, NY 11220
Phone (718) 307-1577

7116 Grand Ave
Maspeth, NY 11378
Phone (718) 307-1577

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1619519717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11213",
            "telephone_number": "718-307-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOLLAK",
        "first_name": "CHRISTINE",
        "credential": "MSN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.