Individual provider Active NPI

Yoel Wartenberg, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rockville Centre, NY
National Provider Identifier
1649824145
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402792 Issued in NY
Practice address
100 N Village Ave Ste 27
Rockville Centre, NY 11570-3712
Phone
(516) 784-0377
NPI assigned
Aug 1, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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 402792 NY Primary

Addresses

Primary practice location

100 N Village Ave Ste 27
Rockville Centre, NY 11570-3712

Mailing address

2 Hazel PL
Woodmere, NY 11598-1108
Phone (516) 784-0377

Other identifiers 1

IdentifierTypeStateIssuer
05911624MedicaidNY

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
I20190913001591 NY Practitioner - Nurse Practitioner 4284963497 Reassigns benefits to 1 organization
Practice locations: Island Park, NY; Rockville Centre, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Long Beach Rd
Island Park, NY 11558-2254
Phone (516) 900-7574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
402792NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Empire NP Psychiatry PC Psychiatric/Mental Health CurrentSince Jun 10, 2020 Accepting new patients
Psychiatric Care Medical PLLC PastSince Nov 10, 2019 Accepting new patients

Locations

100 N Village Ave
Ste 27
Rockville Ctr, NY 11570
Phone (516) 277-6121

Networks

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

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": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1649824145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HAZEL PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981108",
            "telephone_number": "516-784-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N VILLAGE AVE STE 27",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703712",
            "telephone_number": "516-784-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARTENBERG",
        "first_name": "YOEL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-01",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05911624",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.