Individual provider Active NPI

Bernadette Kwitonda, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1962761726
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401446 Issued in NY
Practice address
423 E 23Rd St
New York, NY 10010-5011
Phone
(212) 686-7500
NPI assigned
May 14, 2012
Last updated
Oct 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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 F401446 NY Primary

Addresses

Primary practice location

423 E 23Rd St
New York, NY 10010-5011

Mailing address

423 E 23Rd St
New York, NY 10010-5011

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
I20140428000025 NY Practitioner - Nurse Practitioner 8123251295 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F401446NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Concierge Services, PLLC CurrentSince Aug 28, 2023 Accepting new patients

Locations

1785 Route 9
Halfmoon, NY 12065
Phone (518) 238-6028

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": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1962761726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 E 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 E 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105011",
            "telephone_number": "212-686-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWITONDA",
        "first_name": "BERNADETTE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.