Individual provider Active NPI

Kizzy Massey

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1053788976
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
248 W 108TH St
New York, NY 10025-2956
Phone
(212) 663-3000
NPI assigned
Aug 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

248 W 108TH St
New York, NY 10025-2956

Mailing address

248 W 108TH St
New York, NY 10025-2956
Phone (212) 663-3000

Other identifiers 1

IdentifierTypeStateIssuer
2997620MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240219002567 NY Practitioner - Mental Health Counselor 5698119550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
New York University Medical College - NLG, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PCGroup PAC ID 4082089461, 64 clinicians
The Bridge, Inc.Group PAC ID 3476576273, 11 clinicians

Practice addresses (Care Compare)

2263 James St
Suite 523
Syracuse, NY 13206-3262
Phone (415) 360-3348

248 W 108TH St
New York, NY 10025-2956
Phone (212) 663-3001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008301NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Feb 1, 2024 Accepting new patients
The Bridge, Inc. CurrentSince Jun 9, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

290 Lenox Ave
Fl 3
New York, NY 10027
Phone (870) 476-6003

248 W 108th St
New York, NY 10025
Phone (212) 663-3001

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1053788976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 W 108TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252956",
            "telephone_number": "212-663-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 W 108TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252956",
            "telephone_number": "212-663-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "KIZZY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2997620",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.