Paola Vallaster

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

351768 Issued in NY

Practice address

160 Broadway FL 16
New York, NY 10038-4207

Phone

(917) 261-7370

Fax

(917) 477-6421

NPI assigned

Feb 20, 2024

Last updated

Mar 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ny Ketamine Medical Practice PLLC

  dba NY Ketamine Medical Practice

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1073496402
  Medicare reassignment NPD

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1912762865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BROADWAY FL 16",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384207",
            "telephone_number": "917-261-7370",
            "fax_number": "917-477-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BROADWAY FL 16",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384207",
            "telephone_number": "917-261-7370",
            "fax_number": "917-477-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLASTER",
        "first_name": "PAOLA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christiana Marie Valko
• Marga Valladares-Moreno, LCSW-R
• Ashley Marie Valladares, LMHC
• Annette Therese Vallano, MS RN APRN BC
• Anuradha Vallapureddy
• Sobeyda Valle-Ellis, LCSW
• Agny Gabriela Valle
• Lillian Liduvina Valle, NURSE PRACTITIONER
• Ana Vallecillos
• Wendy Yesenia Vallejo Anzules

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.