Individual provider Active NPI

Carla Luna Williams

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1992211577
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F402311-1 Issued in NY
Practice address
248 W 35TH St
New York, NY 10001-2505
Phone
(718) 681-8700
NPI assigned
Dec 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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 F402311-1 NY Primary

Addresses

Primary practice location

248 W 35TH St
New York, NY 10001-2505

Mailing address

20 Genoa St
West Babylon, NY 11704-1728
Phone (631) 943-3352

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
I20181023001284 NY Practitioner - Nurse Practitioner 0446503346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

1037 Main St
Peekskill, NY 10566-2913
Phone (914) 734-8800

1200 Brown St
Peekskill, NY 10566-2913

3360 Route 343
Amenia, NY 12501-5619
Phone (845) 838-7038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F402311-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Mar 2, 2019 Accepting new patients
New Horizon Counseling Center Inc CurrentSince Dec 1, 2022 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

445 Oak St
Copiague, NY 11726
Phone (631) 257-5173

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

50 W Hawthorne Ave
Valley Stream, NY 11580
Phone (516) 872-9698

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1992211577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GENOA ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117041728",
            "telephone_number": "631-943-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 W 35TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012505",
            "telephone_number": "718-681-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CARLA",
        "middle_name": "LUNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402311-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.