Kathleen Rene, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

309280 Issued in NY

Practice address

57190 Main Rd
Southold, NY 11971-4750

Phone

(631) 626-1006

NPI assigned

Mar 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.rene.1@32021.direct.athenahealth.com

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.

• Queens Village Primary Medical Care, PLLC

  • Primary Care Clinic/Center
  • Queens Village, NY
  • NPI 1164614590
  Medicare reassignment NPD
• Team Care Medical PLLC

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1093531691
  Medicare reassignment NPD
• North Fork House Calls, LLC

  • General Practice Physician
  • Greenport, NY
  • NPI 1326404377
  NPD (past)
• Punam Prabhakar MD PC

  • Neurology Physician
  • Greenvale, NY
  • NPI 1114432226
  NPD (past)

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1053947317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PINE CONE LN",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57190 MAIN RD",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119714750",
            "telephone_number": "631-626-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENE",
        "first_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saundra J Perry, P.T.
• Maria V Purita, LCSW
• Quality Hearing Aid Inc.
• Teresa Ellen Quinn, OTR/L
• Desiree Reese, LCSW
• David E Robinson, D.C.
• Nichole Lynn Rockowitz, NURSE PRACTITIONER
• Deborah Roth, M.S.ED.
• Cathryn Rudder, LMT
• Danielle Lee Ruquet, LMHC

• Adult Health Nurse Practitioner in Southold, NY
• Providers in Southold, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.