Kassandra Petit, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

421490 Issued in NY

Practice address

5201 Haverford Ave
Philadelphia, PA 19139-1401

Phone

(215) 471-2761

NPI assigned

Mar 22, 2021

Last updated

Apr 29, 2022By the provider in NPPES

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, PA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kassandra.petit.p6@direct.usppny.nextgenshare.com

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

• Philadelphia Fight

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1760507859
  Medicare reassignment NPD
• Upper Hudson Planned Parenthood Inc.

  • Clinic/Center
  • Albany, NY
  • NPI 1881755601
  Medicare reassignment NPD
• Philadelphia Fight

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1487082608
  NPD
• Spectrum Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1881629012
  NPD (past)

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1083290860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 HAVERFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191391401",
            "fax_number": "315-222-7435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HAVERFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191391401",
            "telephone_number": "215-471-2761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122061513",
            "country_code": "US",
            "telephone_number": "518-434-5678 x104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETIT",
        "first_name": "KASSANDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "421490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn M. Peterson, D.O.
• Victor Jerome Peterson Sr., MSW
• Anne Louise Petherbridge, DPT
• Laura Catherine Petishnok, MD, MS
• Angetta M Petit, CRNA
• Patricia L Petit, DMD
• Lawrence Petitfrere, PHARM,D,
• Gary Petner, PA-C
• Daria Grazia Petraglia, MSPT
• Ella Petranto

• Women's Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Women's Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.