Kacey Johannah Pryzby, PNP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

382897 Issued in NY

Practice address

444 N Sea Rd
Southampton, NY 11968-2057

Phone

(631) 283-4843

NPI assigned

Aug 6, 2018

Last updated

Aug 6, 2018By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Service League, Inc.

  • Community/Behavioral Health Agency
  • Huntington, NY
  • NPI 1528093242
  NPD (past)
• Hampton Pediatrics, PLLC

  • Pediatrics Physician
  • Southampton, NY
  • NPI 1598989519
  NPD (past)

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1295213700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N SEA RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119682057",
            "telephone_number": "631-283-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N SEA RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119682057",
            "telephone_number": "631-283-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYZBY",
        "first_name": "KACEY",
        "middle_name": "JOHANNAH",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "382897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "382897",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prime Pathology Laboratory, LLC
• Sara Procak, PA-C
• Professional Occupational & Physical Therapy, PLLC
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy, PC
• Kelly Ann Quartuccio-Abbott, MS.ED.
• Maria Radu, DDS DENTIST
• Shakibur Rahman, MD
• Peter Joseph Raia, MD
• Akash Godavarthi Raju

• Pediatrics Physician in Southampton, NY
• Providers in Southampton, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; 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.