Nicole Pichardo, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

406899 Issued in NY

Practice address

113 Glen Cove Ave
Glen Cove, NY 11542-3438

Phone

(516) 622-8888

NPI assigned

Mar 25, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Charles Evans Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bethpage, NY
  • NPI 1972982007
  Medicare reassignment NPD
• Charles Evans Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Seaford, NY
  • NPI 1215596614
  NPD

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1750183497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 GLEN COVE AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 GLEN COVE AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423438",
            "telephone_number": "516-622-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICHARDO",
        "first_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "633341",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Jo Petherick, P.T.
• Philip a. Bonanno, M.D. P.C.
• Reed E Phillips, M.D.
• Susan Lee Phillips, RD
• Physical Therapy Rehab@Home PC
• Zirza A. Pierri, D.D.S.
• Monika Anna Polcwiartek, PA
• Fnu Poonam, MD
• Jennifer Portaro, MS
• Claudia Portillo

• Psychiatric/Mental Health Nurse Practitioner in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.