Individual provider Active NPI

Elizabeth Natasha Durovich, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1639727597
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402788 Issued in NY
Practice address
515 Madison Ave FL 21
New York, NY 10022-5433
Phone
(929) 276-1696
Fax
(914) 999-8520
NPI assigned
Sep 3, 2019
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NJDCATEMP-025091 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 104 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 239247 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402788 NY Primary

Addresses

Primary practice location

515 Madison Ave FL 21
New York, NY 10022-5433

Mailing address

515 Madison Ave FL 21
New York, NY 10022-5433
Phone (929) 276-1696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
239247AZMDPsychiatric/Mental Health Nurse Practitioner
104FLMDPsychiatric/Mental Health Nurse Practitioner
NJDCATEMP-025091NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Psychiatric NP PLLC Psychiatric/Mental Health Past Accepting new patients

Organizations & group practices 1

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": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1639727597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE FL 21",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225433",
            "telephone_number": "929-276-1696",
            "fax_number": "914-999-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE FL 21",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225433",
            "telephone_number": "929-276-1696",
            "fax_number": "914-999-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUROVICH",
        "first_name": "ELIZABETH",
        "middle_name": "NATASHA",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2021-11-04",
        "certification_date": "2021-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "NJDCATEMP-025091",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "104",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "239247",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.