Yasna Jasmine Heravi-Burgos, PSY.D.
Individual provider Active NPI Psychologist · Palm Harbor, FL
NPI 1881997161 · NPPES record last updated Sep 6, 2016
Key facts
- NPI
- 1881997161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PY 9579 (FL)
- Practice address
- 3862 Lancaster CT
Apt. #203
Palm Harbor, FL 34685-4110 - Phone
- (646) 627-4075
- NPI assigned
- Dec 8, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Baycare Behavioral Health Associates, LLC
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
- Mease Countryside Hospital
- Mease Dunedin Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161107002246 | FL | Practitioner - Clinical Psychologist | 3072836972 |
Reassigns benefits to 5 organizations Practice locations: Clearwater, FL |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 9579 | FL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Behavioral Health Associates LLC | Current |
Accepting new patients | |
| Baycare Behavioral Health, Inc | Current |
Accepting new patients | |
| Baycare Behavioral Health Associates LLC | Current |
Accepting new patients | |
| Baycare Behavioral Health Inc. | Current |
Accepting new patients | |
| Baycare Behavioral Health Inc. | Current | Accepting new patients | |
| Behavioral Health Management Services, Inc. | Current | Accepting new patients | |
| Behavioral Health Management Services, Inc | Current |
Accepting new patients | |
| Cotler Healthcare & Development Inc. | Current |
Accepting new patients | |
| Winter Haven Hospital Inc | Current |
Accepting new patients | |
| Behavioral Health Management Services, Inc. | Current |
Accepting new patients |
Locations
1106 Druid Rd S
Ste 201
Clearwater, FL 33756
Phone (727) 442-7181
300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552
1106 Druid Rd S
Clearwater, FL 33756
Phone (727) 584-6266
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
- yasna.heravi-burgospsyd@direct.mybaycare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY 9579 | FL | Yes |
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
Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.