Lavender – Psychiatric/Mental Health Nurse Practitioner, NPI 1518595727
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Lavender
22406 68TH AVE W
MOUNTLAKE TERRACE, WA 980432372
Phone: (855) 444-7258
Fax: (855) 344-8343
Type: Mailing
22406 68th Ave W
Mountlake Terrace, WA 980432372
Phone: (855) 444-7258
Type: Location
245 5TH AVE FL 3
NEW YORK, NY 100168728
Phone: (718) 757-0684
Fax: (855) 344-8343
Type: Location
100 Pine St Ste 1250
San Francisco, CA 941115235
Phone: (855) 444-7258
Fax: (855) 344-8343
Type: Location
6565 N MacArthur Blvd Ste 225
Irving, TX 750392482
Phone: (855) 444-7258
Fax: (855) 344-8343
Type: Location
191 ORCHARD ST APT 4D
NEW YORK, NY 100021424
Phone: (718) 757-0684
Type: Location
79 MAIN ST N
BRIDGEWATER, CT 067521219
Phone: (718) 757-0684
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-05-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-02-28 (103 days ago).
Enrollment records
3
Earliest due date
2026-02-28
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200811001572 | O | Clinic/Group Practice | NY | 2026-02-28 |
| O20250529003475 | O | Clinic/Group Practice | CA | TBD |
| O20250530000612 | O | Clinic/Group Practice | TX | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98043)
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