Individual provider Active NPI

Alexander Gumbs, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Syosset, NY
National Provider Identifier
1750764007
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402677 Issued in NY
Practice address
47 Stuart Dr
Syosset, NY 11791-5123
Phone
(718) 501-7859
NPI assigned
Jul 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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 Nurse Practitioner 363LP0808X F402677 NY Primary
Family Nurse Practitioner 363LF0000X F339743 NY

Addresses

Primary practice location

47 Stuart Dr
Syosset, NY 11791-5123

Mailing address

47 Stuart Dr
Syosset, NY 11791-5123
Phone (718) 501-7859

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
I20161111000910 NY Practitioner - Nurse Practitioner 4385923549 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York Downstate Medical Center, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TBHC Physician Services PCGroup PAC ID 9133265317, 111 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000

175 Jericho Tpke
Suite 117
Syosset, NY 11791-4501
Phone (718) 501-7859

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F339743NYMDFamily Nurse Practitioner
F402677NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
My Medical PC CurrentSince Dec 1, 2021 Accepting new patients
North Shore-Lij Medical PC CurrentSince Sep 6, 2016 Accepting new patients
Mind Over Matter NP in Psychiatry and Family Health P.C. CurrentSince Sep 1, 2021 Accepting new patients
Bridge to Care Nurse Practitioner in Psychiatry PC CurrentSince Jul 1, 2022 Accepting new patients
TBHC Physician Services PC CurrentSince Sep 1, 2024 Accepting new patients
Peyman Younesi MD PLLC Past Accepting new patients

Locations

3438 Bell Blvd
Ste 301
Bayside, NY 11361

147 2nd Ave
Brentwood, NY 11717
Phone (631) 273-7204

6355 Broadway
Bronx, NY 10471
Phone (718) 549-3300

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

340 Trinity St
Malverne, NY 11565
Phone (347) 627-6100

300 Community Dr
Plandome, NY 11030

11502 Ocean Promenade
Rockaway Park, NY 11694
Phone (718) 627-8700

175 Jericho Tpke
Ste 117
Syosset, NY 11791
Phone (516) 496-9041

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: agumbs22373@prd.direct.tbh.org
  • Direct secure messaging: alexander.gumbs.1@24989.direct.athenahealth.com

Organizations & group practices 6

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": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1750764007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 STUART DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915123",
            "telephone_number": "718-501-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 STUART DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915123",
            "telephone_number": "718-501-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMBS",
        "first_name": "ALEXANDER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-06",
        "last_updated": "2021-04-05",
        "certification_date": "2021-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402677",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.