Individual provider Active NPI

Nicholas Banker, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1770060071
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402473 Issued in NY
Practice address
521 5TH Ave
New York, NY 10175-0003
Phone
(914) 740-5287
NPI assigned
Jul 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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 F402473 NY Primary

Addresses

Primary practice location

521 5TH Ave
New York, NY 10175-0003

Mailing address

173D Edgewater Park
Bronx, NY 10465-3514
Phone (347) 541-2388

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
I20200528002502 NY Practitioner - Nurse Practitioner 0749601805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TTC Psychiatric PCGroup PAC ID 5698868818, 3 clinicians

Practice addresses (Care Compare)

333 Adams St
Bedford Hills, NY 10507-2001
Phone (914) 241-0758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F402473NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TTC Psychiatric PC CurrentSince Jun 4, 2020 Accepting new patients
The Therapy Center LLP CurrentSince Jun 4, 2020 Accepting new patients

Locations

333 Adams St
Bedford Hills, NY 10507
Phone (914) 241-0758

280 N Bedford Rd
Ste 304
Mount Kisco, NY 10549
Phone (914) 241-0758

Organizations & group practices 2

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": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1770060071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173D EDGEWATER PARK",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104653514",
            "telephone_number": "347-541-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101750003",
            "telephone_number": "914-740-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKER",
        "first_name": "NICHOLAS",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.