Individual provider Active NPI

Kristen Ann Rielly, CEP

  • Clinical Exercise Physiologist
  • Plandome, NY
National Provider Identifier
1215808233
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
Practice address
40 Brookside Dr
Plandome, NY 11030-1405
Phone
(917) 745-5432
Fax
(516) 627-1356
NPI assigned
Sep 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X Primary

Addresses

Primary practice location

40 Brookside Dr
Plandome, NY 11030-1405

Mailing address

40 Brookside Dr
Plandome, NY 11030-1405
Phone (917) 745-5432

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": "1757894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1215808233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BROOKSIDE DR",
            "city": "PLANDOME",
            "state": "NY",
            "postal_code": "110301405",
            "telephone_number": "917-745-5432",
            "fax_number": "516-627-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BROOKSIDE DR",
            "city": "PLANDOME",
            "state": "NY",
            "postal_code": "110301405",
            "telephone_number": "917-745-5432",
            "fax_number": "516-627-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIELLY",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CEP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plandome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.