Organization Active NPI

Lisa Novak, Nurse Practitioner in Psychiatry, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Yonkers, NY
National Provider Identifier
1811409386
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401402 Issued in NY
Legal business name
LISA NOVAK, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Practice address
35 E Grassy Sprain Rd Ste 304B
Yonkers, NY 10710-4618
Phone
(914) 771-4009
Fax
(914) 771-4110
NPI assigned
Oct 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Lisa Novak, DNP, NPP-BCNPI 1124329537
Title
Nurse Practitioner
Phone
(914) 771-4009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X F401402 NY Primary

Addresses

Primary practice location

35 E Grassy Sprain Rd Ste 304B
Yonkers, NY 10710-4618

Mailing address

1585 Central Park Ave Unit 25
Yonkers, NY 10710-7402
Phone (914) 771-4009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171117000825 NY Part B Supplier - Clinic/Group Practice 9931465374 Receives reassigned benefits from 1 practitioner
Practice locations: Yonkers, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2172882Lisa Novak Nurse Practitioner in Psychiatry, PLLC35 E Grassy Sprain Rd #304B, Yonkers, NY 10710Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Locations

35 E Grassy Sprain Rd
Ste 304B
Yonkers, NY 10710
Phone (914) 771-4009

1585 Central Park Ave
Unit 25
Yonkers, NY 10710

35 E Grassy Sprain Rd
Ste 3LL
Yonkers, NY 10710
Phone (914) 337-4367

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1811409386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 CENTRAL PARK AVE UNIT 25",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107107402",
            "telephone_number": "914-771-4009",
            "fax_number": "914-771-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E GRASSY SPRAIN RD STE 304B",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107104618",
            "telephone_number": "914-771-4009",
            "fax_number": "914-771-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA NOVAK, NURSE PRACTITIONER IN PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "914-771-4009",
        "authorized_official_credential": "DNP, NPP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.