Individual provider Active NPI

Annette Jarrett-Graham, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1669915203
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403590 Issued in NY
Practice address
55 Broad St
New York, NY 10004-2501
Phone
(347) 761-3105
NPI assigned
Nov 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 340714 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403590 NY Primary

Addresses

Primary practice location

55 Broad St
New York, NY 10004-2501

Mailing address

8 Michael F St
Locust Valley, NY 11560-1232
Phone (917) 559-2923

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
I20240702002504 NY Practitioner - Nurse Practitioner 2769766807 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
340714NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Annette Jarrett-Graham Psychiatric/Mental Health Current Accepting new patients
Annette Jarrett-Graham NP in Psychiatry PC Psychiatric/Mental Health CurrentSince Apr 2, 2024 Accepting new patients
Access Clarity LLC Psychiatric/Mental Health CurrentSince Apr 16, 2023 Accepting new patients

Locations

200 Broadhollow Rd
Ste 207
Melville, NY 11747
Phone (516) 906-4970

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": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1669915203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MICHAEL F ST",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601232",
            "telephone_number": "917-559-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BROAD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042501",
            "telephone_number": "347-761-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRETT-GRAHAM",
        "first_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340714",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.