Individual provider Active NPI

Sandy Mompoint

  • Mental Health Counselor
  • Forest Hills, NY
National Provider Identifier
1790926111
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
11835 Queens Blvd Ste 1630
Forest Hills, NY 11375-7256
Phone
(718) 736-3554
Fax
(718) 502-5334
NPI assigned
Mar 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Mental Health Counselor 101YM0800X Primary
Behavior Analyst 103K00000X NY
Professional Counselor 101YP2500X 010278 NY

Addresses

Primary practice location

11835 Queens Blvd Ste 1630
Forest Hills, NY 11375-7256

Mailing address

11835 Queens Blvd Ste 1630
Forest Hills, NY 11375-7256
Phone (718) 736-3554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20251022004095 NY Practitioner - Mental Health Counselor 6901394808 Reassigns benefits to 2 organizations
I20251030004747 NJ Practitioner - Mental Health Counselor 6901394808 Reassigns benefits to 1 organization
I20251121001317 WA Practitioner - Mental Health Counselor 6901394808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical PCGroup PAC ID 4082089461, 64 clinicians

Practice addresses (Care Compare)

2263 James St
Suite 523
Syracuse, NY 13206-3262
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Oct 1, 2025 Accepting new patients
Grow Healthcare Group of New Jersey PC Mental Health CurrentSince Sep 27, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Sep 17, 2025 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

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": "1236988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1790926111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 QUEENS BLVD STE 1630",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757256",
            "telephone_number": "718-736-3554",
            "fax_number": "718-502-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 QUEENS BLVD STE 1630",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757256",
            "telephone_number": "718-736-3554",
            "fax_number": "718-502-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMPOINT",
        "first_name": "SANDY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-14",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NY",
            "license": "010278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.