NPIMap

Individual provider Active NPI

Yasna Jasmine Heravi-Burgos, PSY.D.

  • Psychologist
  • Palm Harbor, FL
National Provider Identifier
1881997161
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY 9579 Issued in FL
Practice address
3862 Lancaster CT
Apt. #203
Palm Harbor, FL 34685-4110
Phone
(646) 627-4075
NPI assigned
Dec 8, 2010
Last updated
Sep 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY 9579 FL Primary

Addresses

Primary practice location

3862 Lancaster CT
Apt. #203
Palm Harbor, FL 34685-4110

Mailing address

3862 Lancaster CT
Apt. #203
Palm Harbor, FL 34685-4110
Phone (646) 627-4075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161107002246 FL Practitioner - Clinical Psychologist 3072836972 Reassigns benefits to 5 organizations
Practice locations: Clearwater, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone (727) 532-1355

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (727) 532-1355

4211 Van Dyke Rd
Lutz, FL 33558-8005
Phone (727) 532-1355

601 Main St
Dunedin, FL 34698-5848
Phone (727) 281-9065

6600 Madison St
New Port Richey, FL 34652-1971
Phone (727) 532-1355

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 9579FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Management Services, Inc. CurrentSince Jul 31, 2019 Accepting new patients
Cotler Healthcare & Development Inc. CurrentSince Aug 16, 2016 Accepting new patients
Baycare Behavioral Health Inc. Current Accepting new patients
Baycare Behavioral Health Associates LLC CurrentSince Jun 12, 2017 Accepting new patients
Behavioral Health Management Services, Inc. Current Accepting new patients
Winter Haven Hospital Inc CurrentSince Jul 31, 2019 Accepting new patients
Behavioral Health Management Services, Inc CurrentSince Jul 31, 2019 Accepting new patients
Baycare Behavioral Health Inc. CurrentSince Jul 31, 2019 Accepting new patients
Baycare Behavioral Health, Inc CurrentSince Jul 31, 2019 Accepting new patients
Baycare Behavioral Health Associates LLC CurrentSince Jun 12, 2017 Accepting new patients

Locations

1106 Druid Rd S
Clearwater, FL 33756
Phone (727) 584-6266

1106 Druid Rd S
Ste 201
Clearwater, FL 33756
Phone (727) 442-7181

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

7809 Massachusetts Ave
Ste 100
New Prt Rchy, FL 34653
Phone (727) 841-4200

6600 Madison St
New Pt Richey, FL 34652
Phone (727) 841-4611

2727 W Mlk Blvd
Ste 640
Tampa, FL 33607
Phone (813) 842-7582

Interoperability endpoints

  • Direct secure messaging: yasna.heravi-burgospsyd@direct.mybaycare.org

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1881997161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3862 LANCASTER CT",
            "address_2": "APT. #203",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346854110",
            "telephone_number": "646-627-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3862 LANCASTER CT",
            "address_2": "APT. #203",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346854110",
            "telephone_number": "646-627-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERAVI-BURGOS",
        "first_name": "YASNA",
        "middle_name": "JASMINE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 9579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.