Individual provider Active NPI

Andrea Beth Cavaluzzi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Elmira, NY
National Provider Identifier
1881239648
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405026 Issued in NY
Practice address
1019 E Water St
Elmira, NY 14901-3332
Phone
(607) 733-5696
Fax
(607) 733-2713
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 477457 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405026 NY Primary

Addresses

Primary practice location

1019 E Water St
Elmira, NY 14901-3332

Mailing address

1019 E Water St
Elmira, NY 14901-3332
Phone (607) 733-5696

Other names 1

  • Andrea Beth Cavaluzzi Professional 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
I20231110000543 NY Practitioner - Nurse Practitioner 8820457823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Family Services of Chemung County IncGroup PAC ID 2365332236, 13 clinicians

Practice addresses (Care Compare)

1019 E Water St
Elmira, NY 14901-3332
Phone (607) 733-5696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
477457NYMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Services of Chemung County, Inc. Psychiatric/Mental Health CurrentSince Jun 5, 2023 Accepting new patients

Locations

1019 E Water St
Elmira, NY 14901
Phone (607) 733-5696

Interoperability endpoints

  • Direct secure messaging: acavaluzzi@fscc.direct.rrhio.org

Organizations & group practices 1

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1881239648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 E WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013332",
            "telephone_number": "607-733-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 E WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013332",
            "telephone_number": "607-733-5696",
            "fax_number": "607-733-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALUZZI",
        "first_name": "ANDREA",
        "middle_name": "BETH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "477457",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "CAVALUZZI",
            "middle_name": "BETH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.