Individual provider Active NPI

Alfa Queny Reynolds, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1841654092
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403637 Issued in NY
Practice address
5030 Broadway Ste 201
New York, NY 10034-1675
Phone
(212) 795-9888
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 701635 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403637 NY Primary

Addresses

Primary practice location

5030 Broadway Ste 201
New York, NY 10034-1675

Mailing address

135 W 50TH St
New York, NY 10020-1201
Phone (646) 648-6243

Other practice location 1

55 Westchester Sq
Bronx, NY 10461-3525
Phone (718) 931-4045

Other names 1

  • Alfa De la Cruz Other name

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
I20220315002566 NY Practitioner - Nurse Practitioner 5799702403 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Supports for Living IncGroup PAC ID 8729992730, 41 clinicians

Practice addresses (Care Compare)

21 Grand St
Newburgh, NY 12550-5628
Phone (845) 562-7244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.65 of 100Reported as group
Quality
71.56
Promoting interoperability
74
Improvement activities
40
Cost
87.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
701635NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family and Children'S Services, Inc. Psychiatric/Mental Health CurrentSince Dec 7, 2021 Accepting new patients
Beacon Place LLC CurrentSince Aug 1, 2024 Accepting new patients
Jewish Board of Family & Childrens Services Inc CurrentSince Dec 7, 2021 Accepting new patients
Access: Supports for Living Inc. CurrentSince Oct 14, 2024 Accepting new patients
Access: Supports for Living Inc Current Accepting new patients

Locations

55 Westchester Sq
Bronx, NY 10461
Phone (718) 239-6149

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

583 State Route 32
Ste 5U
Highland Mills, NY 10930
Phone (845) 827-6680

583 State Route 32
Highland Mls, NY 10930
Phone (845) 203-1400

5030 Broadway
Ste 201
New York, NY 10034
Phone (212) 632-4749

67 Windsor Hwy
Newburgh, NY 12553
Phone (845) 562-6850

21 Grand St
Newburgh, NY 12550
Phone (845) 562-7244

15 Fortune Rd W
Scotchtown, NY 10941
Phone (845) 673-7123

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1841654092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W 50TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201201",
            "telephone_number": "646-648-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 BROADWAY STE 201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341675",
            "telephone_number": "212-795-9888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Westchester Sq",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104613525",
            "country_code": "US",
            "telephone_number": "718-931-4045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ALFA QUENY",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "701635",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALFA",
            "last_name": "DE LA CRUZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.