GREAT WATER LAND SERVICES NURSE PRACTITIONER IN PSYCHIATRY PLLC
NPI 1386463040
Nurse Practitioner - Psychiatric/Mental Health in Massapequa, NY
About Great Water Land Services Nurse Practitioner In Psychiatry Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREAT WATER LAND SERVICES NURSE PRACTITIONER IN PSYCHIATRY PLLC (NPI 1386463040) is a healthcare organization registered as a psychiatric/mental health in Massapequa, New York and active in the NPI registry since October 2024. The organization lists Jill Ryan, Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 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)
Great Water Land Services Nurse Practitioner In Psychiatry Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Great Water Land Services Nurse Practitioner In Psychiatry PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Great Water Land Services Nurse Practitioner In Psychiatry PLLC's NPI number?
The NPI number for Great Water Land Services Nurse Practitioner In Psychiatry PLLC is 1386463040. It was assigned to this organization in the NPPES registry on October 8, 2024.
Where is Great Water Land Services Nurse Practitioner In Psychiatry PLLC located?
Great Water Land Services Nurse Practitioner In Psychiatry PLLC is located at 166 Euclid Ave, Massapequa, NY 11758. The listed phone number is (516) 695-0389.
What is Great Water Land Services Nurse Practitioner In Psychiatry PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Great Water Land Services Nurse Practitioner In Psychiatry PLLC enrolled in Medicare?
Yes. Great Water Land Services Nurse Practitioner In Psychiatry PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Great Water Land Services Nurse Practitioner In Psychiatry PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Great Water Land Services Nurse Practitioner In Psychiatry 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Great Water Land Services Nurse Practitioner In Psychiatry PLLC was last updated on October 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Great Water Land Services Nurse Practitioner In Psychiatry Pllc · NPI 1386463040
Psychiatric/Mental Health organization in Massapequa, New York. Organization record, active in the CMS NPPES registry since October 8, 2024.
## Identity
- **NPI:** 1386463040 (Entity type: Organization)
- **Enumerated:** October 8, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Jill Ryan, NURSE PRACTITIONER
## Practice location
- **Address:** 166 EUCLID AVE, Massapequa, NY 11758-4207
- **Phone:** (516) 695-0389 · **Fax:** (956) 253-4627
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 8, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1386463040) · Data from the CMS NPPES public registry.