Individual provider Active NPI

J Kristine Rendal-Sattem, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1922696681
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403819-01 Issued in NY
Practice address
1775 Grand Concourse
Bronx, NY 10453-8202
Phone
(212) 665-1860
Fax
(718) 294-4034
NPI assigned
Jan 7, 2021
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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 Nurse Practitioner 363LP0808X 403819-01 NY Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 618249 NY

Addresses

Primary practice location

1775 Grand Concourse
Bronx, NY 10453-8202

Mailing address

1775 Grand Concourse
Bronx, NY 10453-8202
Phone (212) 665-1860

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL BRONX Health Information Exchange (HIE)

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
I20220604000160 NY Practitioner - Nurse Practitioner 0143608091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aldad Medical PCGroup PAC ID 9234291436, 78 clinicians

Practice addresses (Care Compare)

510 Hempstead Tpke
RM 203
West Hempstead, NY 11552-1152
Phone (516) 505-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
618249NYMDPsychiatric/Mental Health Registered Nurse
403819-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aldad Medical PC CurrentSince Apr 1, 2022 Accepting new patients

Locations

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

15715 19th Ave
Whitestone, NY 11357
Phone (718) 559-0580

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, 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": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1922696681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104538202",
            "telephone_number": "212-665-1860",
            "fax_number": "718-294-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104538202",
            "telephone_number": "212-665-1860",
            "fax_number": "718-294-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDAL-SATTEM",
        "first_name": "J KRISTINE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2022-06-03",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403819-01",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "618249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BRONX",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "BRONX",
            "address_1": "1775 Grand Concourse",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104538202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.