Individual provider Active NPI

Kelly Eckhoff, FNP

  • Dermatology Physician
  • Garden City, NY
National Provider Identifier
1184568925
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
F359002 Issued in NY
Practice address
1111 Franklin Ave
Garden City, NY 11530-1617
Phone
(516) 739-1141
NPI assigned
Apr 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X F359002 NY Primary

Addresses

Primary practice location

1111 Franklin Ave
Garden City, NY 11530-1617

Mailing address

97 Radio Ave
Miller Place, NY 11764-3126
Phone (631) 792-3319

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
I20260611001197 NY Practitioner - Nurse Practitioner 8224500103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F359002NYMDDermatology Physician

Organizations & group practices 1

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": "1776124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1184568925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 RADIO AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117643126",
            "telephone_number": "631-792-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301617",
            "telephone_number": "516-739-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKHOFF",
        "first_name": "KELLY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "F359002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.