Kristian Devera Zacarias, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

353630 Issued in NY

Practice address

11506 Beach Channel Dr Ste 101
Rockaway Park, NY 11694-2113

Phone

(718) 474-7744

NPI assigned

Feb 26, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prominis Medical Services PCGroup PAC ID 9537124441, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (3 of 7)

Locations

Networks

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

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.

• Prominis Medical Services PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1841323771
  Medicare reassignment Care Compare group NPD
• Peninsula Medical Care PLLC

  • Urgent Care Clinic/Center
  • Rockaway Park, NY
  • NPI 1851663926
  NPD
• Comprehensive Women'S Health of N.Y. PLLC

  • Obstetrics & Gynecology Physician
  • Glendale, NY
  • NPI 1982736047
  NPD (past)

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1285490268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 MARYLAND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053039",
            "telephone_number": "646-423-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11506 BEACH CHANNEL DR STE 101",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942113",
            "telephone_number": "718-474-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACARIAS",
        "first_name": "KRISTIAN",
        "middle_name": "DEVERA",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Leigh Wilson, D.M.D.
• Xiaoting Wu
• Rafael Yakutilov, M.D.
• Yashodhara Kirtane M.D.PLLC
• Catherine Louise Yeager, LMT
• Shumaila Zafar
• Tamara Zargarova
• Brian Harris Zwerling, M.D.
• Jeffrey F Zwerling, MD
• Jonathan Zwerling, M.D.

• Family Nurse Practitioner in Rockaway Park, NY
• Providers in Rockaway Park, 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 Feb 26, 2024; 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.