Individual provider Active NPI

Eileen Kilgus-Reid, MS, RN, FNP-BC

  • Family Nurse Practitioner
  • Commack, NY
National Provider Identifier
1245702059
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341360 Issued in NY
Practice address
650 Commack Rd
Commack, NY 11725
Phone
(631) 623-4253
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 341360 NY Primary

Addresses

Primary practice location

650 Commack Rd
Commack, NY 11725

Mailing address

650 Commack Rd
Commack, NY 11725-5404
Phone (631) 623-4253

Other practice location 1

2A Windsor Pl
Lynbrook, NY 11563-3724
Phone (516) 250-8329

Other practice location 2

2A Windsor Pl
Lynbrook, NY 11563-3724
Phone (516) 250-8329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
341360NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1245702059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255404",
            "telephone_number": "631-623-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "11725",
            "telephone_number": "631-623-4253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2A Windsor Pl",
            "address_purpose": "LOCATION",
            "city": "Lynbrook",
            "state": "NY",
            "postal_code": "115633724",
            "country_code": "US",
            "telephone_number": "516-250-8329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2A Windsor Pl",
            "address_purpose": "LOCATION",
            "city": "Lynbrook",
            "state": "NY",
            "postal_code": "115633724",
            "country_code": "US",
            "telephone_number": "516-250-8329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILGUS-REID",
        "first_name": "EILEEN",
        "credential": "MS, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.