Individual provider Active NPI

Yissell Delvalle, MD

  • Psychiatry Physician
  • Englewood, NJ
National Provider Identifier
1750585709
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA08210700 Issued in NJ
Practice address
14 N Dean St
Englewood, NJ 07631-2807
Phone
(917) 345-4273
Fax
(201) 460-0913
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA08210700 NJ Primary

Addresses

Primary practice location

14 N Dean St
Englewood, NJ 07631-2807

Mailing address

6000 Washington St
West New York, NJ 07093-1420
Phone (201) 864-4897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070905000682 NJ Practitioner - PsychiatryPractitioner - Addiction Medicine 8325131402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Rutgers New Jersey Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatry on Video LLCGroup PAC ID 6800269432, 6 clinicians
Premier Psychiatric Consultants, LLCGroup PAC ID 7315077120, 6 clinicians

Practice addresses (Care Compare)

6000 Washington St
West New York, NJ 07093-1420
Phone (201) 490-4075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Psychiatric Consultants LLC CurrentSince Apr 9, 2010 Accepting new patients
Psychiatry on Video LLC Psychiatry CurrentSince Feb 15, 2023 Accepting new patients
Palisade Behavioral Care, PA Psychiatry PastSince Jun 12, 2022 Accepting new patients
NJ Behavioral Care Inc. Psychiatry PastSince Nov 1, 2021 Accepting new patients

Locations

14 N Dean St
Englewood, NJ 07631
Phone (201) 646-8015

235 Prospect Ave
Ste Lf
Hackensack, NJ 07601
Phone (201) 489-0099

Organizations & group practices 4

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1750585709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 WASHINGTON ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931420",
            "telephone_number": "201-864-4897",
            "fax_number": "201-460-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 N DEAN ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312807",
            "telephone_number": "917-345-4273",
            "fax_number": "201-460-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELVALLE",
        "first_name": "YISSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA08210700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.