NY KETAMINE MEDICAL PRACTICE PLLC
NPI 1073496402
Clinic/Center - Mental Health (Including Community Mental Health Center) in New York, NY
About Ny Ketamine Medical Practice Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NY KETAMINE MEDICAL PRACTICE PLLC (NPI 1073496402), doing business as Ny Ketamine Medical Practice, is a healthcare organization registered as a mental health (including community mental health center) in New York, New York and active in the NPI registry since July 2025. The organization maintains a secondary practice location in Melville and lists Heather Okeefe, Chief Financial Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ny Ketamine Medical Practice Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Ny Ketamine Medical Practice PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ny Ketamine Medical Practice PLLC's NPI number?
The NPI number for Ny Ketamine Medical Practice PLLC is 1073496402. It was assigned to this organization in the NPPES registry on July 31, 2025. The provider is doing business as NY Ketamine Medical Practice.
Where is Ny Ketamine Medical Practice PLLC located?
Ny Ketamine Medical Practice PLLC is located at 160 Broadway Fl 16, New York, NY 10038. The listed phone number is (917) 261-7370.
What is Ny Ketamine Medical Practice PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Ny Ketamine Medical Practice PLLC enrolled in Medicare?
Yes. Ny Ketamine Medical Practice PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ny Ketamine Medical Practice PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Ny Ketamine Medical Practice PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), Emergency Medicine (1) and Psychiatry (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Ny Ketamine Medical Practice PLLC was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ny Ketamine Medical Practice Pllc · NPI 1073496402
Mental Health (Including Community Mental Health Center) organization in New York, New York. Organization record, active in the CMS NPPES registry since July 31, 2025.
## Identity
- **NPI:** 1073496402 (Entity type: Organization)
- **Enumerated:** July 31, 2025
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Also known as:** NY Ketamine Medical Practice (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Heather Okeefe, CHIEF FINANCIAL OFFICER
## Practice location
- **Address:** 160 BROADWAY FL 16, New York, NY 10038-4207
- **Phone:** (917) 261-7370 · **Fax:** (917) 477-6421
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Emergency Medicine (1), Psychiatry (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 3, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1073496402) · Data from the CMS NPPES public registry.