Individual provider Active NPI

Molly Kate Trevail, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1669874921
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402736 Issued in NY
Practice address
243 5TH Ave FL 3
New York, NY 10016-8703
Phone
(332) 249-7435
Fax
(855) 646-9321
NPI assigned
Sep 18, 2014
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 430853 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402736 NY Primary

Addresses

Primary practice location

243 5TH Ave FL 3
New York, NY 10016-8703

Mailing address

245 5TH Ave FL 3
New York, NY 10016-8728

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
I20141113001432 NY Practitioner - Nurse Practitioner 3971725680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatric Nurse Practitioner PCGroup PAC ID 6901221795, 45 clinicians

Practice addresses (Care Compare)

191 Orchard St
Apt 4D
New York, NY 10002-1424
Phone (718) 534-0689

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
430853NYMDAcute Care Nurse Practitioner
402736NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Oct 13, 2014 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jan 1, 2020 Accepting new patients
Albany Medical College CurrentSince Jan 1, 2020 Accepting new patients
Psychiatric Nurse Practitioner P.C Psychiatric/Mental Health CurrentSince Nov 25, 2024 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Oct 13, 2014 Accepting new patients
Albany Medical College Current Accepting new patients

Locations

1365 Washington Ave
Albany, NY 12206
Phone (518) 435-1300

1365 Washington Ave
Ste 300
Albany, NY 12206
Phone (518) 489-4704

43 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5149

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

6 Medical Park Dr
Ste 203
Malta, NY 12020
Phone (518) 264-1200

1275 Broadway
Menands, NY 12204
Phone (518) 262-9705

245 5th Ave
Fl 3
New York, NY 10016
Phone (212) 302-4399

Organizations & group practices 8

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1669874921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168703",
            "telephone_number": "332-249-7435",
            "fax_number": "855-646-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVAIL",
        "first_name": "MOLLY",
        "middle_name": "KATE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430853",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.