NPIMap

Individual provider Active NPI

Samantha A. Kelly, CRNA

  • Certified Registered Nurse Anesthetist
  • Rockville Centre, NY
National Provider Identifier
1275557852
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
487061 Issued in NY
Practice address
1000 N. Village Ave
Rockville Centre, NY 11570
Phone
(516) 705-1200
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 487061 NY Primary

Addresses

Primary practice location

1000 N. Village Ave
Rockville Centre, NY 11570

Mailing address

194-04 111TH Road
St. Albans, NY 11412-2019
Phone (718) 479-0245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110405000180 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517141237 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Cardiovascular Anesthesiologists, P.C.Group PAC ID 5799676623, 135 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians
Jamaica Anesthesiologist PCGroup PAC ID 1355323460, 80 clinicians

Practice addresses (Care Compare)

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 627-6624

530 1St Ave
New York, NY 10016-6402

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-6088

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
487061NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 1, 2022 Accepting new patients
Jamaica Anesthesiologist, PC CurrentSince Nov 1, 2022 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Apr 1, 2018 Accepting new patients
New York Cardiovascular Anesthesiologists, P.C. CurrentSince May 1, 2025 Accepting new patients
New York University Current Accepting new patients
Long Island Anesthesia Physicians LLP CurrentSince Jan 27, 2018 Accepting new patients
New York University CurrentSince Aug 1, 2022 Accepting new patients

Locations

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

1000 N Village Ave
Ste 508
Rockville Ctr, NY 11570
Phone (516) 764-7900

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

Networks

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

Organizations & group practices 7

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.

Hospital & facility affiliations 11

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275557852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194-04 111TH ROAD",
            "city": "ST. ALBANS",
            "state": "NY",
            "postal_code": "114122019",
            "telephone_number": "718-479-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N. VILLAGE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11570",
            "telephone_number": "516-705-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SAMANTHA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "487061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.