Individual provider Active NPI

Nichole Marie McLeod, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lancaster, NY
National Provider Identifier
1730858721
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405506 Issued in NY
Practice address
5775 Broadway St
Lancaster, NY 14086-2456
Phone
(716) 544-8848
Fax
(888) 612-0831
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 732698 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405506 NY Primary

Addresses

Primary practice location

5775 Broadway St
Lancaster, NY 14086-2456

Mailing address

81 Dartwood Dr
Cheektowaga, NY 14227-3121
Phone (716) 578-5788

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
I20250224001264 NY Practitioner - Nurse Practitioner 1557881307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatric Nurse Practitioner PCGroup PAC ID 6901221795, 45 clinicians
Integrative Nurse Practitioner in Psychiatry PLLCGroup PAC ID 4385149574, 3 clinicians

Practice addresses (Care Compare)

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

5775 Broadway St
Suite 14
Lancaster, NY 14086-2456
Phone (716) 544-8848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
732698NYMDPsychiatric/Mental Health Registered Nurse
405506NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Nurse Practitioner P.C Psychiatric/Mental Health CurrentSince Nov 23, 2024 Accepting new patients
Integrative Nurse Practitioner in Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jun 30, 2025 Accepting new patients

Locations

5775 Broadway St
Ste 14
Lancaster, NY 14086
Phone (716) 544-8848

5775 Broadway St
Lancaster, NY 14086
Phone (716) 427-4803

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

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": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1730858721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 DARTWOOD DR",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142273121",
            "telephone_number": "716-578-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 BROADWAY ST",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140862456",
            "telephone_number": "716-544-8848",
            "fax_number": "888-612-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "732698",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, NY

Sources for this page

Verify at the official NPI Registry.