Individual provider Active NPI

Kristen Michele Woodard, M.D.

  • Pediatrics Physician
  • Rye Brook, NY
National Provider Identifier
1063671394
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
248778-1 Issued in NY
Practice address
26 Rye Ridge PLZ
Rye Brook, NY 10573-2820
Phone
(914) 251-1100
Fax
(914) 251-1109
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 248778-1 NY Primary

Addresses

Primary practice location

26 Rye Ridge PLZ
Rye Brook, NY 10573-2820

Mailing address

26 Rye Ridge PLZ
Rye Brook, NY 10573-2820
Phone (914) 251-1100

Other names 1

  • Dr. Kristen Michele Pompizzi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181206003582 CT Practitioner - Pediatric Medicine 7810231529 Reassigns benefits to 1 organization
I20181207000181 NY Practitioner - Pediatric Medicine 7810231529 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
248778-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Pediatrics CurrentSince Oct 21, 2018 Accepting new patients
Northeast Medical Group, PLLC Pediatrics CurrentSince Oct 21, 2018 Accepting new patients

Locations

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

26 Rye Ridge Plz
Rye Brook, NY 10573
Phone (914) 251-1100

18 Rye Ridge Plz
Rye Brook, NY 10573
Phone (914) 253-9252

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1063671394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 RYE RIDGE PLZ",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105732820",
            "telephone_number": "914-251-1100",
            "fax_number": "914-251-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 RYE RIDGE PLZ",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105732820",
            "telephone_number": "914-251-1100",
            "fax_number": "914-251-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "KRISTEN",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "248778-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "POMPIZZI",
            "middle_name": "MICHELE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rye Brook, NY

Sources for this page

Verify at the official NPI Registry.