Active NPI
Kristen Canzler
- Nurse Practitioner
- Ithaca, NY
National Provider Identifier
1124781877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 310153
- Practice address
- 1229 Trumansburg Rd
Ithaca, NY 14850-1313 - Phone
- (607) 273-8072
- NPI assigned
- Oct 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 310153 | NY | Primary |
Addresses
Primary practice location
1229 Trumansburg Rd
Ithaca, NY 14850-1313
Mailing address
1229 Trumansburg Rd
Ithaca, NY 14850-1313
Other practice location 1
2450 Beaver Dams Moreland Rd
Beaver Dams, NY 14812-9428
Phone (607) 438-6955
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220216000652 | NY | Practitioner - Nurse Practitioner | 2668865650 | Reassigns benefits to 3 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
- Schuyler Hospital Inc
Practice addresses (Care Compare)
220 Steuben St
Montour Falls, NY 14865-9740
Phone 607535863952353
Hospital & facility affiliations
- Schuyler Hospital
- Arnot Ogden Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.27 of 100
- Quality
- 82.87
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.27 of 100
- Quality
- 82.87
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 310153 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cayuga Medical Associates, PC | Current | Accepting new patients | |
| Schuyler Hospital Inc | Current | Accepting new patients | |
| Schuyler Hospital Inc | Current | Accepting new patients | |
| Schuyler Hospital Inc | Current | Accepting new patients |
Locations
1229 Trumansburg Rd
Ithaca, NY 14850
Phone (315) 797-3570
310 Taughannock Blvd
Fl 4
Ithaca, NY 14850
Phone (607) 269-0100
101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011
220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121
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.
-
- Medicare Defined Swing Bed Hospital Unit
- Montour Falls, NY
- NPI 1740364181
-
- Rural Health Clinic/Center
- Montour Falls, NY
- NPI 1417580697
-
- Skilled Nursing Facility
- Montour Falls, NY
- NPI 1871574848
-
- Rural Health Clinic/Center
- Ovid, NY
- NPI 1902430689
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657670400000",
"number": "1124781877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1229 TRUMANSBURG RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 TRUMANSBURG RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501313",
"telephone_number": "607-273-8072"
}
],
"practiceLocations": [
{
"address_1": "2450 Beaver Dams Moreland Rd",
"address_purpose": "LOCATION",
"city": "Beaver Dams",
"state": "NY",
"postal_code": "148129428",
"country_code": "US",
"telephone_number": "607-438-6955",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CANZLER",
"first_name": "KRISTEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-20",
"last_updated": "2022-07-13",
"certification_date": "2022-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "310153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.