Individual provider Active NPI

Tali Kluk Kusnir, DNP-FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1083421663
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355812 Issued in NY
Practice address
1221 E 14TH St
Brooklyn, NY 11230-4803
Phone
(317) 608-7584
NPI assigned
Dec 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 866333 NY
Family Nurse Practitioner 363LF0000X 355812 NY Primary

Addresses

Primary practice location

1221 E 14TH St
Brooklyn, NY 11230-4803

Mailing address

223 Franklin PL
Woodmere, NY 11598-1133
Phone (317) 608-7584

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250306001741 NY Practitioner - Nurse Practitioner 0345761334 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shakespeare Operating LLCGroup PAC ID 0840604310, 144 clinicians

Practice addresses (Care Compare)

1250 Shakespeare Ave
Bronx, NY 10452-3012
Phone (646) 350-1633

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
866333NYMDRegistered Nurse
355812NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bronx Medical Practice P.C. CurrentSince Jan 3, 2025 Accepting new patients
Essen Medical Associates, PC CurrentSince Jan 3, 2025 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Jan 3, 2025 Accepting new patients
Shakespeare Operating LLC CurrentSince Jan 3, 2025 Accepting new patients
Essen Medical Associates, PC CurrentSince Jan 3, 2025 Accepting new patients

Locations

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

5235 Broadway
Ste C
Bronx, NY 10463
Phone (646) 350-1633

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

3991 White Plains Rd
Ste C
Bronx, NY 10466
Phone (718) 925-3454

1250 Shakespeare Ave
Bronx, NY 10452
Phone (646) 350-1633

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 7

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": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1083421663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 FRANKLIN PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981133",
            "telephone_number": "317-608-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304803",
            "telephone_number": "317-608-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUK KUSNIR",
        "first_name": "TALI",
        "credential": "DNP-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "866333",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.