Individual provider Active NPI

Cassondra Irene Calandrillo, NP

  • Acute Care Nurse Practitioner
  • Kew Gardens Hills, NY
National Provider Identifier
1104395334
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F431439-1 Issued in NY
Practice address
6701 136TH St Unit a
Kew Gardens Hills, NY 11367-1623
Phone
(917) 972-8643
NPI assigned
Nov 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F431439-1 NY Primary

Addresses

Primary practice location

6701 136TH St Unit a
Kew Gardens Hills, NY 11367-1623

Mailing address

6701 136TH St Unit a
Kew Gardens Hills, NY 11367-1623
Phone (917) 972-8643

Other practice location 1

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

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
I20200804000825 NY Practitioner - Nurse Practitioner 8123443413 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F431439-1NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Anesthesiology Group CurrentSince Mar 1, 2020 Accepting new patients
Mskcc Surgery Group CurrentSince Jun 19, 2022 Accepting new patients
Memorial Neurology Group CurrentSince Jun 19, 2022 Accepting new patients

Locations

633 3rd Ave
New York, NY 10017

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

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

Interoperability endpoints

  • Direct secure messaging: ccalandrillo40127@mskcc.direct-ci.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": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1104395334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 136TH ST UNIT A",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "113671623",
            "telephone_number": "917-972-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 136TH ST UNIT A",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "113671623",
            "telephone_number": "917-972-8643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "212-639-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALANDRILLO",
        "first_name": "CASSONDRA",
        "middle_name": "IRENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F431439-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens Hills, NY

Sources for this page

Verify at the official NPI Registry.