Individual provider Active NPI

Kaleigh A Marino, RPA-C

  • Physician Assistant
  • Lynbrook, NY
National Provider Identifier
1104069970
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013142 Issued in NY
Practice address
266 Merrick Rd
Lynbrook, NY 11563-2640
Phone
(516) 826-7800
Fax
(516) 826-7836
NPI assigned
Apr 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013142 NY Primary

Addresses

Primary practice location

266 Merrick Rd
Lynbrook, NY 11563-2640

Mailing address

6 Joludow Dr
Massapequa Park, NY 11762-3720
Phone (631) 678-7872

Other names 1

  • Kaleigh Chimenti Former name

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
I20101101000145 NY Practitioner - Physician Assistant 5294929576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massapequa Dermatology PLLCGroup PAC ID 2769637941, 6 clinicians

Practice addresses (Care Compare)

70 Grand Ave
Massapequa, NY 11758-4906
Phone (516) 799-1600

Merit-based Incentive Payment System (MIPS)

Final score
74.96 of 100Reported as individual
Quality
49.92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013142NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Island Dermatology, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kaleigh@massapequaderm.emadirect.md

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": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1104069970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 JOLUDOW DR",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117623720",
            "telephone_number": "631-678-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 MERRICK RD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632640",
            "telephone_number": "516-826-7800",
            "fax_number": "516-826-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "KALEIGH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALEIGH",
            "last_name": "CHIMENTI",
            "credential": "RPA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynbrook, NY

Sources for this page

Verify at the official NPI Registry.