Individual provider Active NPI

Dara Yastrzemski, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Walton, NY
National Provider Identifier
1962153809
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
404147 Issued in NY
Practice address
243 Delaware St
Walton, NY 13856-1019
Phone
(607) 832-5888
Fax
(607) 832-6081
NPI assigned
Jan 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 404147 NY Primary

Addresses

Primary practice location

243 Delaware St
Walton, NY 13856-1019

Mailing address

243 Delaware St
Walton, NY 13856-1019
Phone (607) 832-5888

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
I20220712000334 NY Practitioner - Nurse Practitioner 4880074509 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.28 of 100Reported as group
Quality
88.2
Promoting interoperability
100
Improvement activities
40
Cost
69.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Jun 27, 2022 Accepting new patients
Delaware County CurrentSince Apr 30, 2024 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jun 27, 2022 Accepting new patients
Delaware County CurrentSince Apr 30, 2024 Accepting new patients
Psychiatry Faculty Practice, Inc. CurrentSince Aug 1, 2023 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

600 E Genesee St
Ste 217
Syracuse, NY 13202
Phone (315) 452-0300

719 Harrison St
Syracuse, NY 13210
Phone (315) 464-3265

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

243 Delaware St
Walton, NY 13856
Phone (607) 832-5888

Interoperability endpoints

  • Direct secure messaging: dyastrzemski@hiemail.healtheconnections.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1962153809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 DELAWARE ST",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561019",
            "telephone_number": "607-832-5888",
            "fax_number": "607-832-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 DELAWARE ST",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561019",
            "telephone_number": "607-832-5888",
            "fax_number": "607-832-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASTRZEMSKI",
        "first_name": "DARA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walton, NY

Sources for this page

Verify at the official NPI Registry.