Individual provider Active NPI

Jodie Deignan, NPP, PMHNP-BC, MT-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1770614745
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401321 Issued in NY
Practice address
180 S Broadway Ste 301a
White Plains, NY 10605-1820
Phone
(914) 216-7550
Fax
(412) 900-1132
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 6309491 NY
Music Therapist 225A00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12.010154 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2351852 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401321 NY Primary

Addresses

Primary practice location

180 S Broadway Ste 301a
White Plains, NY 10605-1820

Mailing address

55 McKinley Ave Apt DG-8
White Plains, NY 10606-1659
Phone (508) 317-2486

Other practice location 1

13 Steeple St Ste 202
Mashpee, MA 02649-3287
Phone (914) 216-7550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150209001591 NY Practitioner - Nurse Practitioner 4789909003 Reassigns benefits to 3 organizations
I20220214000098 MA Practitioner - Nurse Practitioner 4789909003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13 Steeple St
Suite 202
Mashpee, MA 02649-3287
Phone (914) 216-7550

180 S Broadway
Suite 301a
White Plains, NY 10605-1857
Phone (914) 216-7550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6309491NYMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
12.010154CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. CurrentSince Nov 1, 2014 Accepting new patients
Premier Healthcare, Inc. CurrentSince Nov 1, 2014 Accepting new patients
Julia Dyckman Andrus Memorial, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Jodie Deignan Nurse Practitioner in Psychiatry PLLC Psychiatric/Mental Health CurrentSince Dec 23, 2020 Accepting new patients

Locations

13 Steeple St
Ste 202
Mashpee, MA 02649
Phone (508) 562-7390

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

180 S Broadway
Ste 301A
White Plains, NY 10605
Phone (914) 216-7550

19 Greenridge Ave
White Plains, NY 10605
Phone (914) 949-7680

50 Main St
Ste 1000
White Plains, NY 10606
Phone (914) 216-7550

1156 N Broadway
Yonkers, NY 10701
Phone (914) 965-3700

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1770614745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MCKINLEY AVE APT DG-8",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106061659",
            "telephone_number": "508-317-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S BROADWAY STE 301A",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051820",
            "telephone_number": "914-216-7550",
            "fax_number": "412-900-1132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Steeple St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Mashpee",
            "state": "MA",
            "postal_code": "026493287",
            "country_code": "US",
            "telephone_number": "914-216-7550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEIGNAN",
        "first_name": "JODIE",
        "credential": "NPP, PMHNP-BC, MT-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NY",
            "license": "6309491",
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.010154",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2351852",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.