Individual provider Active NPI

Alexandra Gavalo-Yacco, DNP, FNP-BC

  • Family Nurse Practitioner
  • Brewster, NY
National Provider Identifier
1639787955
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345563 Issued in NY
Practice address
100 Independent Way Ste H
Brewster, NY 10509-6303
Phone
(845) 279-2000
NPI assigned
Jul 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F345563 NY Primary

Addresses

Primary practice location

100 Independent Way Ste H
Brewster, NY 10509-6303

Mailing address

100 S Bedford Rd
Mount Kisco, NY 10549-3425
Phone (845) 554-6620

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
I20201110001922 NY Practitioner - Nurse Practitioner 4486064037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F345563NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Nov 9, 2020 Accepting new patients
Senior Moments Care NP in Adult Health PLLC CurrentSince Aug 21, 2024 Accepting new patients
Optum Medical Care, P.C. CurrentSince Nov 9, 2020 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

100 Independent Way
Ste H
Brewster, NY 10509
Phone (845) 279-2000

111 Bedford Rd
Katonah, NY 10536
Phone (914) 232-3135

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

360 N Bedford Rd
Mount Kisco, NY 10549
Phone (844) 484-6564

777 Westchester Ave
Ste 101
White Plains, NY 10604
Phone (646) 302-3306

Philadelphia, PA 19195

Networks

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

Interoperability endpoints

  • Direct secure messaging: agavaloyacco142524@direct.optum.com
  • Direct secure messaging: agavaloyacco377050@northwell.direct-ci.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1639787955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S BEDFORD RD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493425",
            "telephone_number": "845-554-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INDEPENDENT WAY STE H",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105096303",
            "telephone_number": "845-279-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVALO-YACCO",
        "first_name": "ALEXANDRA",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.