Keisha Antoinette Mahoney, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

33339112 Issued in NY

Practice address

20 Steven PL
Smithtown, NY 11787-5423

Phone

(516) 754-0073

NPI assigned

Aug 23, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Keisha Hines Professional name

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fulton Medical PCGroup PAC ID 8527201540, 19 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.71 of 100Reported as group

Quality

79.66

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fulton Medical, P.C.

  • Internal Medicine Physician
  • Massapequa, NY
  • NPI 1841635133
  Medicare reassignment Care Compare group NPD
• Long Island Medical Services P.C.

  • Internal Medicine Physician
  • Syosset, NY
  • NPI 1841443538
  Medicare reassignment NPD
• Hematology and Oncology of Li PLLC

  • Hematology & Oncology Physician
  • Massapequa, NY
  • NPI 1629275938
  NPD (past)

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

{
    "created_epoch": "1408752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408752000000",
    "number": "1255731501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 STEVEN PL",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875423",
            "telephone_number": "516-754-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 STEVEN PL",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875423",
            "telephone_number": "516-754-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "KEISHA",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-23",
        "last_updated": "2014-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33339112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEISHA",
            "last_name": "HINES",
            "prefix": "MRS.",
            "credential": "N.P",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Frank Maggio
• Casey Morgan Maguffin, PHARM.D
• Timothy Brian Mahan, N,P,
• Linda Mahler, NP
• Joan Catherine Mahoney, NP
• Kelley A Mahoney, RN
• Christie Leigh Maier, M.A
• Andrew Makrides, M.D.
• Taylor Malefato
• Audra Marie Malerba, D.O.

• Family Nurse Practitioner in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.