Organization Active NPI

VJM NP in Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Westbury, NY
National Provider Identifier
1851164917
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
VJM NP IN PSYCHIATRY PLLC
Practice address
38 Fawn LN
Westbury, NY 11590-6528
Phone
(516) 680-3221
NPI assigned
Nov 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Viji MeledathNPI 1669962791
Title
Owner
Phone
(516) 680-3221

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: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

38 Fawn LN
Westbury, NY 11590-6528

Mailing address

38 Fawn LN
Westbury, NY 11590-6528

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240506001781 NY Part B Supplier - Clinic/Group Practice 9537509641 Receives reassigned benefits from 1 practitioner
Practice locations: Albany, NY

National Provider Directory

National Provider Directory

Locations

418 Broadway
Ste 5595
Albany, NY 12207
Phone (518) 396-5569

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": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1851164917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 FAWN LN",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 FAWN LN",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906528",
            "telephone_number": "516-680-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VJM NP IN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "MELEDATH",
        "authorized_official_first_name": "VIJI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-680-3221"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.