Organization Active NPI

South Shore NP Psychiatry, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wantagh, NY
National Provider Identifier
1629847124
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SOUTH SHORE NP PSYCHIATRY, PLLC
Practice address
3330 Park Avenue
Suite 9 2ND Floor
Wantagh, NY 11793-3719
Phone
(516) 931-0619
Fax
(516) 879-3099
NPI assigned
Dec 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

Name
Tatyana Goykhberg, PMHNPNPI 1326699679
Title
NP
Phone
(347) 741-9301

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

3330 Park Avenue
Suite 9 2ND Floor
Wantagh, NY 11793-3719

Mailing address

3330 Park Avenue
Suite 9 2ND Floor
Wantagh, NY 11793-3719
Phone (516) 931-0619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240201002864 NY Part B Supplier - Clinic/Group Practice 7810340205 Receives reassigned benefits from 1 practitioner
Practice locations: Wantagh, NY

National Provider Directory

National Provider Directory

Locations

3330 Park Ave
Wantagh, NY 11793
Phone (516) 730-3447

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1629847124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 PARK AVENUE",
            "address_2": "SUITE 9 2ND FLOOR",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933719",
            "telephone_number": "516-931-0619",
            "fax_number": "516-879-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 PARK AVENUE",
            "address_2": "SUITE 9 2ND FLOOR",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933719",
            "telephone_number": "516-931-0619",
            "fax_number": "516-879-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE NP PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-26",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "GOYKHBERG",
        "authorized_official_first_name": "TATYANA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "347-741-9301",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.