STALEY PSYCHIATRIC NURSE PRACTITIONER PLLC
NPI 1316581267
Psychiatry & Neurology - Psychiatry in Hollis, NY

Q: What is Staley Psychiatric Nurse Practitioner PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Active since November 04, 2019

19605 FOOTHILL AVE, HOLLIS, NY 11423(718) 470-2245(718) 470-2245 Get Directions Write a Review

NPPES record last updated: November 4, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Staley Psychiatric Nurse Practitioner Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STALEY PSYCHIATRIC NURSE PRACTITIONER PLLC (NPI 1316581267) is a healthcare organization registered as a psychiatry in Hollis, New York and active in the NPI registry since November 2019. The organization lists Angela Douglas-staley, President, as its authorized official.

NPPES Registry Identity

NPI1316581267

Entity TypeOrganization

Primary Taxonomy2084P0800X

Legal Business NameSTALEY PSYCHIATRIC NURSE PRACTITIONER PLLC

Location Address19605 FOOTHILL AVEHollis, NY 11423-1413

Mailing Address19605 Foothill AveHollis, NY 11423-1413 · (718) 470-2245 · Fax (718) 470-2245

Phone(718) 470-2245

Fax(718) 470-2245

Organization SubpartNo

Authorized OfficialAngela Douglas-staleyPresident · (718) 470-2245

Enumeration DateNovember 4, 2019

✔ NPI 1316581267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

19605 FOOTHILL AVE, Hollis, NY 11423

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Staley Psychiatric Nurse Practitioner Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Staley Psychiatric Nurse Practitioner PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Bobby Staley, L.C.S.W.

Clinical Social Worker

NPI 1649512112

19605 FOOTHILL AVE
Hollis, NY 11423

(917) 680-0082

✔ PECOS✔ Accepts MedicareSame address

Angela Douglas Staley, RN, NP

Nurse Practitioner

NPI 1538469770

2369 2ND AVE
New York, NY 10035

(212) 876-2300

✔ PECOS10 mi

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 Staley Psychiatric Nurse Practitioner PLLC's NPI number?

The NPI number for Staley Psychiatric Nurse Practitioner PLLC is 1316581267. It was assigned to this organization in the NPPES registry on November 4, 2019.

Where is Staley Psychiatric Nurse Practitioner PLLC located?

Staley Psychiatric Nurse Practitioner PLLC is located at 19605 Foothill Ave, Hollis, NY 11423. The listed phone number is (718) 470-2245.

What is Staley Psychiatric Nurse Practitioner PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Staley Psychiatric Nurse Practitioner PLLC enrolled in Medicare?

Yes. Staley Psychiatric Nurse Practitioner PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Staley Psychiatric Nurse Practitioner PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Staley Psychiatric Nurse Practitioner PLLC, in Clinical Social Worker and Nurse Practitioner. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Staley Psychiatric Nurse Practitioner PLLC was last updated on November 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.