NPIMap

Organization Active NPI

Tri-Star Behavioral Health Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Vernon, NY
National Provider Identifier
1639655293
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
TRI-STAR BEHAVIORAL HEALTH INC
Practice address
6 Gramatan Ave Ste 606
Mount Vernon, NY 10550-3208
Phone
(212) 961-7299
Fax
(844) 636-5521
NPI assigned
Jul 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Patrick Tigenoah, NPNPI 1306187059
Title
Owner
Phone
(347) 340-9652

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

6 Gramatan Ave Ste 606
Mount Vernon, NY 10550-3208

Mailing address

6 Gramatan Ave Ste 606
Mount Vernon, NY 10550-3208
Phone (347) 340-9652

Other practice location 1

11 W Prospect Ave Fl 3
Mount Vernon, NY 10550
Phone (347) 340-9652

Other practice location 2

6 Gramatan Ave Ste 606
Mount Vernon, NY 10550-3208
Phone (914) 469-7454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220503001379 NY Part B Supplier - Clinic/Group Practice 6002203437 Receives reassigned benefits from 7 practitioners
Practice locations: Bronx, NY; Mount Vernon, NY
O20240320002217 CT Part B Supplier - Clinic/Group Practice 6002203437 Receives reassigned benefits from 1 practitioner
Practice locations: Westport, CT

National Provider Directory

National Provider Directory

Locations

11 W Prospect Ave
Fl 3
Mount Vernon, NY 10550
Phone (347) 340-9652

Practitioners & affiliated clinicians

Practitioners 8

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": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1639655293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GRAMATAN AVE STE 606",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105503208",
            "telephone_number": "347-340-9652",
            "fax_number": "844-636-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GRAMATAN AVE STE 606",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105503208",
            "telephone_number": "212-961-7299",
            "fax_number": "844-636-5521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 W Prospect Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "NY",
            "postal_code": "10550",
            "country_code": "US",
            "telephone_number": "347-340-9652",
            "fax_number": "844-636-5521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Gramatan Ave Ste 606",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "NY",
            "postal_code": "105503208",
            "country_code": "US",
            "telephone_number": "914-469-7454",
            "fax_number": "844-636-5521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRI-STAR BEHAVIORAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "TIGENOAH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-340-9652",
        "authorized_official_credential": "NP"
    },
    "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 Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.