Individual provider Active NPI

Sady-Ann Robinson, RN, MSN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rock Tavern, NY
National Provider Identifier
1851740385
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405637 Issued in NY
Practice address
42 Wayland Way
Rock Tavern, NY 12575-5219
Phone
(347) 742-2996
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 9171921 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405637 NY Primary

Addresses

Primary practice location

42 Wayland Way
Rock Tavern, NY 12575-5219

Mailing address

42 Wayland Way
Rock Tavern, NY 12575-5219
Phone (347) 742-2996

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
I20240626004281 NY Practitioner - Nurse Practitioner 8022552462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of OrangeGroup PAC ID 0648169185, 28 clinicians

Practice addresses (Care Compare)

146 Pike St
Port Jervis, NY 12771-1808
Phone (845) 856-1458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
9171921NYMDRegistered Nurse
405637NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange CurrentSince May 19, 2024 Accepting new patients
County of Orange CurrentSince May 19, 2024 Accepting new patients
Litson Certified Care, Inc. Past Accepting new patients
Willcare Past Accepting new patients

Locations

30 Harriman Dr
Goshen, NY 10924
Phone (845) 291-2600

146 Pike St
Port Jervis, NY 12771
Phone (845) 856-1458

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1851740385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 WAYLAND WAY",
            "city": "ROCK TAVERN",
            "state": "NY",
            "postal_code": "125755219",
            "telephone_number": "347-742-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 WAYLAND WAY",
            "city": "ROCK TAVERN",
            "state": "NY",
            "postal_code": "125755219",
            "telephone_number": "347-742-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "SADY-ANN",
        "credential": "RN, MSN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "9171921",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Tavern, NY

Sources for this page

Verify at the official NPI Registry.