NPIMap

Organization Active NPI

Illuminate NP Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Orchard Park, NY
National Provider Identifier
1871184424
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ILLUMINATE NP PSYCHIATRY
Practice address
3595 Eggert Rd
Orchard Park, NY 14127-1929
Phone
(716) 903-6036
Fax
(716) 463-2225
NPI assigned
Jan 27, 2021
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Authorized official

Name
Amy KotarskiNPI 1013470350
Title
Owner
Phone
(716) 903-6036

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 Practitioner 363LP0808X Primary

Addresses

Primary practice location

3595 Eggert Rd
Orchard Park, NY 14127-1929

Mailing address

3595 Eggert Rd
Orchard Park, NY 14127-1929
Phone (716) 903-6036

Other identifiers 1

IdentifierTypeStateIssuer
05703237MedicaidNY

Other names 1

  • Illuminate NP Psychiatry, PLLC Other name

National Provider Directory

National Provider Directory

Locations

337 Cleveland Dr
Ste 1
Cheektowaga, NY 14215
Phone (716) 202-0474

3595 Eggert Rd
Orchard Park, NY 14127
Phone (716) 662-2478

30 S Cayuga Rd
Ste 106
Williamsville, NY 14221

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1871184424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3595 EGGERT RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271929",
            "telephone_number": "716-903-6036",
            "fax_number": "716-463-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 EGGERT RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271929",
            "telephone_number": "716-903-6036",
            "fax_number": "716-463-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATE NP PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "KOTARSKI",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-903-6036"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05703237",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illuminate NP Psychiatry, PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Illuminate NP Psychiatry, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.