Individual provider Active NPI

Yui Kitayama, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1639633530
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP714808 Issued in GA
Practice address
72 Jaques Ave
Worcester, MA 01610-2476
Phone
(508) 860-1294
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 APRN-NP714808 GA Primary

Addresses

Primary practice location

72 Jaques Ave
Worcester, MA 01610-2476

Mailing address

PO Box 95
Decatur, GA 30031-0095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190827002270 MA Practitioner - Nurse Practitioner 9830427962 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2326641MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthlink, Inc. CurrentSince Jul 19, 2019 Accepting new patients
Community Healthlink Inc CurrentSince Jul 19, 2019 Accepting new patients

Locations

40 Spruce St
#2
Leominster, MA 01453
Phone (978) 534-6116

26 Queen St
Worcester, MA 01610
Phone (508) 860-7700

72 Jaques Ave
Worcester, MA 01610
Phone (508) 860-1154

Interoperability endpoints

  • Direct secure messaging: yuikitayama@direct2.communityhealthlink.org

Organizations & group practices 2

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": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1639633530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300310095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 JAQUES AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102476",
            "telephone_number": "508-860-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITAYAMA",
        "first_name": "YUI",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP714808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.