Individual provider Active NPI

Kevin Fischer, RN

  • Registered Nurse
  • Brentwood, NY
National Provider Identifier
1164068946
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
775616-01 Issued in NY
Practice address
998 Crooked Hill Rd
Brentwood, NY 11717-1019
Phone
(631) 761-3500
NPI assigned
Nov 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 775616-01 NY Primary

Addresses

Primary practice location

998 Crooked Hill Rd
Brentwood, NY 11717-1019

Mailing address

219 Blue Point Rd
Oakdale, NY 11769-2214
Phone (213) 905-2214

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
775616-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1164068946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 BLUE POINT RD",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117692214",
            "telephone_number": "213-905-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-761-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "KEVIN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "775616-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.