Individual provider Active NPI

Patricia Bernstein, N.P.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Grove, NY
National Provider Identifier
1649526690
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401505 Issued in NY
Practice address
2780 Middle Country Rd Ste 306
Lake Grove, NY 11755-2126
Phone
(631) 981-8300
NPI assigned
Jul 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 401505 NY Primary

Addresses

Primary practice location

2780 Middle Country Rd Ste 306
Lake Grove, NY 11755-2126

Mailing address

646 Main St Ste 201
Port Jefferson, NY 11777-2230
Phone (631) 981-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
401505NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1649526690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 MAIN ST STE 201",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772230",
            "telephone_number": "631-981-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 MIDDLE COUNTRY RD STE 306",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552126",
            "telephone_number": "631-981-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "PATRICIA",
        "credential": "N.P.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

Verify at the official NPI Registry.