Nicole Louis Beaubrun, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403215 Issued in NY

Practice address

1211 Howells Rd
Bay Shore, NY 11706-1945

Phone

(631) 586-3501

NPI assigned

Jul 30, 2009

Last updated

Jul 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Nicole Louis Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nys Office of Mental Health

  • Adult Mental Health Clinic/Center
  • West Brentwood, NY
  • NPI 1578627485
  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  NY

  Medicare reassignment NPD
• Serenemind NP in Adult Health &Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bay Shore, NY
  • NPI 1376494963
  Authorized official Same address or phone
• Nys Office of Mental Health

  • Adult Mental Health Clinic/Center
  • Rochester, NY
  • NPI 1730243643
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1780815480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 HOWELLS RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117061945",
            "telephone_number": "631-586-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HOWELLS RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117061945",
            "telephone_number": "631-586-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUBRUN",
        "first_name": "NICOLE",
        "middle_name": "LOUIS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305199",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "LOUIS",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bayshore Home Healthcare, Inc .
• Bayshore Medical Care, P.C.
• Bayshore Vision Center,Inc.
• Bayshore Vision Express, LLC (Cohen's Fashion Optical)
• Madeline Beakes, OTR
• Deborah Beauplan
• Erica Beauplan, DO
• David Joseph Beccia, M.D.
• Lisa Becker Lipner, PT
• Tomasina Beckford, LCSWR

• Psychiatric/Mental Health Nurse Practitioner in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.