Individual provider Active NPI

Michelle McNair

  • Psychiatric/Mental Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1659615169
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402497-1 Issued in NY
Practice address
5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138
Phone
(718) 548-1161
NPI assigned
Nov 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 607520-1 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F402497-1 NY Primary

Addresses

Primary practice location

5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138

Mailing address

5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138

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
I20190618002375 NY Practitioner - Nurse Practitioner 0042544439 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
607520-1NYMDRegistered Nurse
F402497-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family & Childrens Services Inc CurrentSince May 6, 2019 Accepting new patients
Jewish Board of Family and Children'S Services, Inc. Psychiatric/Mental Health CurrentSince May 6, 2019 Accepting new patients
Advantage Care Diagnostic and Treatment Center ,Inc CurrentSince Apr 13, 2022 Accepting new patients

Locations

521 W 239th St
Bronx, NY 10463
Phone (718) 601-2280

750 Astor Ave
Bronx, NY 10467
Phone (718) 882-5000

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

230 Hanse Ave
Freeport, NY 11520
Phone (516) 686-4400

189 Wheatley Rd
Glen Head, NY 11545
Phone (516) 626-1075

Networks

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

Organizations & group practices 3

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": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1659615169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5676 RIVERDALE AVE",
            "address_2": "SUITE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5676 RIVERDALE AVE",
            "address_2": "SUITE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712138",
            "telephone_number": "718-548-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAIR",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "607520-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402497-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.