Individual provider Active NPI

Kristina Alexandria Cabales, LAC

  • Acupuncturist
  • Oakdale, NY
National Provider Identifier
1114597929
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
007082 Issued in NY
Practice address
889 Montauk Hwy
Oakdale, NY 11769-1702
Phone
(631) 337-2022
Fax
(631) 751-8298
NPI assigned
Jun 25, 2021
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 19032 CA
Acupuncturist 171100000X 007082 NY Primary

Addresses

Primary practice location

889 Montauk Hwy
Oakdale, NY 11769-1702

Mailing address

889 Montauk Hwy
Oakdale, NY 11769-1702
Phone (631) 337-2022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007082NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
My Acupuncturist PLLC Acupuncturist CurrentSince Jun 21, 2022 Accepting new patients
Modern Roots Acupuncture PC Acupuncturist PastSince Jun 21, 2022 Accepting new patients
Libs Chiropractic Center, Inc. PastSince Jun 1, 2021 Accepting new patients

Locations

889 Montauk Hwy
Oakdale, NY 11769
Phone (631) 337-2022

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1114597929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691702",
            "telephone_number": "631-337-2022",
            "fax_number": "631-751-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691702",
            "telephone_number": "631-337-2022",
            "fax_number": "631-751-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALES",
        "first_name": "KRISTINA",
        "middle_name": "ALEXANDRIA",
        "name_prefix": "Dr.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19032",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "007082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.