Individual provider Active NPI

Martina A Sannoh, PMHNP-BC

  • Psychiatry Physician
  • Brentwood, NY
National Provider Identifier
1871071746
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
F406341 Issued in NY
Practice address
998 Crooked Hill Rd
Brentwood, NY 11717-1019
Phone
(631) 761-3652
Fax
(631) 761-3661
NPI assigned
Aug 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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 652205-1 NY
Psychiatry Physician 2084P0800X F406341 NY Primary

Addresses

Primary practice location

998 Crooked Hill Rd
Brentwood, NY 11717-1019

Mailing address

998 Crooked Hill Rd BLDG 69
Brentwood, NY 11717-1019
Phone (631) 579-3997

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
I20250520001357 NY Practitioner - Nurse Practitioner 6709304041 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
652205-1NYMDRegistered Nurse
F406341NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Care Medical PLLC Psychiatry CurrentSince Mar 27, 2025 Accepting new patients
Long Island Select Healthcare, Inc. CurrentSince Aug 23, 2025 Accepting new patients
Long Island Select Healthcare, Inc. CurrentSince Aug 23, 2025 Accepting new patients
New York Neuromodulation Medical PLLC Psychiatry Past Accepting new patients

Locations

159 Carleton Ave
Central Islip, NY 11722
Phone (631) 439-4300

120 Plant Ave
Hauppauge, NY 11788
Phone (631) 273-1300

883 E Main St
Riverhead, NY 11901
Phone (631) 284-5500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1871071746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD BLDG 69",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-579-3997",
            "fax_number": "631-761-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-761-3652",
            "fax_number": "631-761-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANNOH",
        "first_name": "MARTINA",
        "middle_name": "A",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-02",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "652205-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "F406341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

Verify at the official NPI Registry.