Individual provider Active NPI

Ngonga Frustelle Nana

  • Psychiatric/Mental Health Nurse Practitioner
  • Morrisonville, NY
National Provider Identifier
1740859743
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
699731 Issued in NY
Practice address
2155 State Route 22B
Morrisonville, NY 12962-3417
Phone
(518) 563-8000
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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 699731 NY Primary

Addresses

Primary practice location

2155 State Route 22B
Morrisonville, NY 12962-3417

Mailing address

2155 State Route 22B
Morrisonville, NY 12962-3417
Phone (518) 563-8000

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
I20210831003007 NY Practitioner - Nurse Practitioner 1456757434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2155 State Route 22B
Morrisonville, NY 12962-3417
Phone (518) 563-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
699731NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Services North, Inc. CurrentSince Aug 23, 2021 Accepting new patients
Behavioral Health Services North, Inc. CurrentSince Aug 23, 2021 Accepting new patients
Orenda Psychiatry PLLC Psychiatric/Mental Health Past Accepting new patients

Locations

2155 State Route 22B
Morrisonville, NY 12962
Phone (518) 562-3847

22 US Oval
Ste 218
Plattsburgh, NY 12903
Phone (518) 534-9666

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1740859743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 STATE ROUTE 22B",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "129623417",
            "telephone_number": "518-563-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 STATE ROUTE 22B",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "129623417",
            "telephone_number": "518-563-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANA",
        "first_name": "NGONGA",
        "middle_name": "FRUSTELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "699731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisonville, NY

Sources for this page

Verify at the official NPI Registry.