Individual provider Active NPI

Patricia Fogarty, PM HNP

  • Psychiatric/Mental Health Nurse Practitioner
  • West Babylon, NY
National Provider Identifier
1750750485
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
404482 Issued in NY
Practice address
17 Fordham Road
West Babylon, NY 11704-5803
Phone
(631) 321-7011
Fax
(631) 669-8532
NPI assigned
Sep 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 404482 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 404482 NY Primary
School Registered Nurse 163WS0200X 471230 NY

Addresses

Primary practice location

17 Fordham Road
West Babylon, NY 11704-5803

Mailing address

17 Fordham Road
West Babylon, NY 11704-5803
Phone (631) 321-7011

Other practice location 1

445 Broadhollow Rd Ste 25
Melville, NY 11747-3645
Phone (610) 972-9446

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
I20221129000238 NY Practitioner - Nurse Practitioner 8022486869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heart and Soul Community CounselingGroup PAC ID 1951644657, 8 clinicians

Practice addresses (Care Compare)

609 Route 109
Suite 1C
West Babylon, NY 11704-5072
Phone (631) 321-7011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
471230NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fogartyjones LLC Psychiatric/Mental Health Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Mar 14, 2023 Accepting new patients
Heart & Soul Community Counseling Psychiatric/Mental Health CurrentSince Oct 30, 2022 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

429 Montauk Hwy
East Quogue, NY 11942
Phone (631) 321-7011

445 Broadhollow Rd
Ste 25
Melville, NY 11747
Phone (516) 807-8787

300 Community Dr
Plandome, NY 11030

1400 Wantagh Ave
Ste L2
Wantagh, NY 11793
Phone (516) 559-0194

17 Fordham Rd
West Babylon, NY 11704
Phone (631) 321-7011

609 Route 109
Ste 1C
West Babylon, NY 11704
Phone (631) 321-7011

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": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1750750485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 FORDHAM ROAD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117045803",
            "telephone_number": "631-321-7011",
            "fax_number": "631-669-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 FORDHAM ROAD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117045803",
            "telephone_number": "631-321-7011",
            "fax_number": "631-669-8532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 Broadhollow Rd Ste 25",
            "address_purpose": "LOCATION",
            "city": "Melville",
            "state": "NY",
            "postal_code": "117473645",
            "country_code": "US",
            "telephone_number": "610-972-9446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "PM HNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "404482",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404482",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "471230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

Verify at the official NPI Registry.