Patricia Desjarlais, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Alexandria Bay, NY
NPI 1962886812 · NPPES record last updated Feb 4, 2016
Key facts
- NPI
- 1962886812
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- F401840 (NY)
- Practice address
- 4 Fuller St
Alexandria Bay, NY 13607-1316 - Phone
- (315) 482-1230
- Fax
- (315) 482-5553
- NPI assigned
- Jul 9, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Neighborhood Center, Inc
Practice addresses (Care Compare)
628 Mary St
Utica, NY 13501-2419
Phone (315) 272-2700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160510000851 | NY | Practitioner - Nurse Practitioner | 7315911013 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F401840 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Neighborhood Center, Inc. | Current |
Accepting new patients | |
| River Hospital, Inc. | Current |
Accepting new patients | |
| River Hospital, Inc. | Current |
Accepting new patients |
Locations
4 Fuller St
Alexandria Bay, NY 13607
Phone (315) 482-1277
624 Elizabeth St
Utica, NY 13501
Phone (315) 272-2600
Interoperability endpoints
- pdesjarlais@hiemail.healtheconnections.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F401840 | NY | Yes |
Addresses
Primary practice location
4 Fuller St
Alexandria Bay, NY 13607-1316
Mailing address
4 Fuller St
Alexandria Bay, NY 13607-1316
Phone (315) 482-1230
Other providers in Alexandria Bay, NY
- Richard F Corcoran
- Creative Optical, LLC
- Nelly Johana Davis-Rodriguez
- James Steven Demer
- Erica Denner
- Julia Ann Erck
- Gloria Ann Fisher
- Kaitlin M. Ford
- Nickolas Frears
- Bradley Duane Frey
All providers in Alexandria Bay, NY · Psychiatric/Mental Health Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 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.