Individual provider Active NPI

Preethi Alex

  • Psychiatric/Mental Health Registered Nurse
  • Staten Island, NY
National Provider Identifier
1831605054
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
562104 Issued in NY
Practice address
777 Seaview Avenue
Staten Island, NY 10305-3409
Phone
(718) 667-2508
NPI assigned
Dec 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 562104 NY Primary

Addresses

Primary practice location

777 Seaview Avenue
Staten Island, NY 10305-3409

Mailing address

777 Seaview Ave
Staten Island, NY 10305-3409

Other identifiers 1

IdentifierTypeStateIssuer
2997157MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230829001734 NY Order and Referring Only - Nurse Practitioner 5991168601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
562104NYMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nys Office of Mental Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1831605054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409",
            "telephone_number": "718-667-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEX",
        "first_name": "PREETHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-26",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "562104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2997157",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.