Individual provider Active NPI

Misty Kammarada, LAC, MSTOM

  • Acupuncturist
  • Brooklyn, NY
National Provider Identifier
1154619799
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
004629 Issued in NY
Practice address
581 5TH Ave
Suite 1
Brooklyn, NY 11215-8407
Phone
(718) 965-0555
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 004629 NY Primary

Addresses

Primary practice location

581 5TH Ave
Suite 1
Brooklyn, NY 11215-8407

Mailing address

29 N Lakeside Ave
Jackson, NJ 08527-2747
Phone (732) 859-6957

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

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1154619799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 N LAKESIDE AVE",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272747",
            "telephone_number": "732-859-6957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 5TH AVE",
            "address_2": "SUITE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112158407",
            "telephone_number": "718-965-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMARADA",
        "first_name": "MISTY",
        "credential": "LAC, MSTOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "004629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.