Individual provider Active NPI

Kristal Mikesha Pierre, NP

  • Adult Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1174899892
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305359 Issued in NY
Practice address
1250 Waters PL
Tower 1, Suite 602
Bronx, NY 10461-2720
Phone
(917) 946-5059
NPI assigned
Mar 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305359 NY Primary

Addresses

Primary practice location

1250 Waters PL
Tower 1, Suite 602
Bronx, NY 10461-2720

Mailing address

1250 Waters PL
Tower 1, Suite 602
Bronx, NY 10461-2720
Phone (917) 946-5059

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
I20140404000008 NY Practitioner - Nurse Practitioner 9032341185 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Health PCGroup PAC ID 9032308267, 44 clinicians

Practice addresses (Care Compare)

661 N Main St
Spring Valley, NY 10977-2319
Phone (845) 354-1212

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespire, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Genesis Medical Health PC CurrentSince Sep 1, 2019 Accepting new patients
Care Connect Medical P.C. CurrentSince Sep 1, 2023 Accepting new patients
Lifespire, Inc. CurrentSince Jan 1, 2014 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

21301 Northern Blvd
Fl 2
Bayside, NY 11361
Phone (718) 721-5444

7 Skyline Dr
Ste 250
Hawthorne, NY 10532

16210 Jamaica Ave
Ste 7
Jamaica, NY 11432
Phone (718) 454-2700

225 Maple Ave
Monsey, NY 10952
Phone (845) 352-9000

33 Downtown Dr
Fl 3
Monsey, NY 10952
Phone (201) 357-1520

15 Monsey Blvd
Monsey, NY 10952
Phone (845) 356-3400

199 N Middletown Rd
Nanuet, NY 10954
Phone (845) 353-4344

661 N Main St
Spring Valley, NY 10977
Phone (845) 228-3350

Networks

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

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1174899892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "address_2": "TOWER 1, SUITE 602",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612720",
            "telephone_number": "917-946-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "address_2": "TOWER 1, SUITE 602",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612720",
            "telephone_number": "917-946-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "KRISTAL",
        "middle_name": "MIKESHA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.