Organization provider

QUEENS NASSAU MENTAL HEALTH COUNSELING PLLC

Exclusive Provider Organization Mental Health Counselor Medicare enrolled

QUEENS NASSAU MENTAL HEALTH COUNSELING PLLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1093336125, based in New Hyde Park, NY. The organization lists 2 taxonomy classifications, with Exclusive Provider Organization recorded as primary.

Getting there

The practice address on file is 40 SOUTH 16TH STREET, New Hyde Park, NY 11040. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

40 SOUTH 16TH STREET, New Hyde Park, NY 11040 Open in Google Maps →

Credentials and Medicare

State licence

NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.

Medicare (PECOS)
Status
Approved
Provider type
Part B Supplier - Clinic/group Practice
PAC ID
6204379076
Enrollment ID
O20240620004018

Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Exclusive Provider Organization covers

(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. NUCC Health Care Provider Taxonomy, code 302F00000X
Managed Care Organizations Exclusive Provider Organization

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
302F00000X Exclusive Provider Organization primary
101YM0800X Mental Health Counselor Mental Health

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.

NPI1093336125 valid check digit
Entity typeOrganization (NPI-2)
Enumeration dateApr 29, 2020
Last updatedApr 29, 2020
StatusActive
Practice address 40 SOUTH 16TH STREET
New Hyde Park, NY 11040
(917) 933-0584
Fax (718) 806-1435
The last update on file is Apr 29, 2020. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1093336125 passes the NPI check digit test The final digit 5 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 0 9 3 3 3 6 1 2
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 0 9 3 6 3 3 1 4

Sum = 55 · next multiple of 10 = 60 · check digit = 5 · actual last digit = 5

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1093336125?
NPI 1093336125 is the National Provider Identifier assigned to QUEENS NASSAU MENTAL HEALTH COUNSELING PLLC in New Hyde Park, NY. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Exclusive Provider Organization cover?
(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO…
How do I contact QUEENS NASSAU MENTAL HEALTH COUNSELING PLLC?
The phone number on file with NPPES is (917) 933-0584, last updated Apr 29, 2020. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does QUEENS NASSAU MENTAL HEALTH COUNSELING PLLC accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1093336125 a valid number?
Yes. 1093336125 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.