Peter Joseph Valastro Jr., NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F403526-01 Issued in NY

Practice address

37 Everts Ave
Queensbury, NY 12804-2040

Phone

(518) 793-4700

Fax

(518) 793-6325

NPI assigned

Feb 11, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 13, 2021 through Jul 13, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Parsons Child and Family Center

  • Custodial Care Facility
  • Albany, NY
  • NPI 1922171305
  NPD (past)

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1811529415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4705",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128040705",
            "telephone_number": "518-245-3837",
            "fax_number": "518-899-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 EVERTS AVE",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042040",
            "telephone_number": "518-793-4700",
            "fax_number": "518-793-6325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Dixon Rd",
            "address_purpose": "LOCATION",
            "city": "Queensbury",
            "state": "NY",
            "postal_code": "128042133",
            "country_code": "US",
            "telephone_number": "518-245-3837",
            "fax_number": "518-245-3840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "63 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Saratoga Spgs",
            "state": "NY",
            "postal_code": "128663023",
            "country_code": "US",
            "telephone_number": "518-636-5284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALASTRO",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-11",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "704435",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403526",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403526-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06428115",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Leigh Tyrer, COTA/L
• Susan Marie Tyrrell, CRPA
• United Cerebral Palsy Association of the Tri-Counties, Inc.
• United Cerebral Palsy Association of the Tri-Counties, Inc.
• Upstate Applied Behavior Analysis Services PLLC
• Tara A Vanburen, OTR/L
• Amanda Grace Vanderzee
• Mark R Vandien, RPA
• Melissa Vanorden, RN
• Ashley Varco

• Psychiatric/Mental Health Nurse Practitioner in Queensbury, NY
• Providers in Queensbury, 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 Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.