Individual provider Active NPI

Ketsia Marie Guerrier

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1881878866
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403733 Issued in NY
Practice address
306 Malcolm X Blvd
New York, NY 10027-4465
Phone
(212) 803-2850
NPI assigned
Dec 26, 2007
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403733 NY Primary

Addresses

Primary practice location

306 Malcolm X Blvd
New York, NY 10027-4465

Mailing address

276 5TH Ave RM 704
New York, NY 10001-4527
Phone (212) 683-9100

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
I20220304001889 NY Practitioner - Nurse Practitioner 0547654659 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Room AIDS Ministry, Inc. Adult Day Health Care Center. Multi-Specialty CurrentSince Dec 6, 2021 Accepting new patients
Catholic Charities Neighborhood Services, Inc. Multi-Specialty CurrentSince Jan 10, 2024 Accepting new patients
Shlomit Levy PastSince Dec 6, 2021 Accepting new patients
Catholic Charities Neigborhood Services Past Accepting new patients

Locations

1623 Flatbush Ave
Brooklyn, NY 11210
Phone (718) 377-5755

191 Joralemon St
Fl 11
Brooklyn, NY 11201

6729 Myrtle Ave
Glendale, NY 11385
Phone (718) 456-7001

169 W 133rd St
New York, NY 10030
Phone (646) 762-4950

306 Malcolm X Blvd
Fl 3
New York, NY 10027
Phone (212) 803-2850

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1881878866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 5TH AVE RM 704",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014527",
            "telephone_number": "212-683-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MALCOLM X BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274465",
            "telephone_number": "212-803-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRIER",
        "first_name": "KETSIA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.