Individual provider Active NPI

Kaitlin Brown, AGPCNP, WHNP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1083124820
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308486 Issued in NY
Practice address
198 E 121St St FL 5
New York, NY 10035-3523
Phone
(212) 801-3300
NPI assigned
Oct 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 308486 NY Primary

Addresses

Primary practice location

198 E 121St St FL 5
New York, NY 10035-3523

Mailing address

4215 Crescent Street
Luna Lic, Apt 9N
Queens, NY 11101
Phone (931) 698-2448

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180409000644 NY Practitioner - Family Practice 0042573826 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
308486NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kaitlinbrown@mai.allscriptsdirect.net
  • Direct secure messaging: kaitlin.brown@jmc.eclinicaldirectplus.com

Organizations & group practices 3

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": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1083124820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 CRESCENT STREET",
            "address_2": "LUNA LIC, APT 9N",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11101",
            "telephone_number": "931-698-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 E 121ST ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353523",
            "telephone_number": "212-801-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KAITLIN",
        "name_prefix": "Ms.",
        "credential": "AGPCNP, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.