Individual provider Active NPI

Kerriann Ventuzelo

  • Licensed Practical Nurse
  • East Islip, NY
National Provider Identifier
1295615656
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
268506-01 Issued in NY
Practice address
55 Suffolk LN
East Islip, NY 11730-2211
Phone
(631) 428-5672
NPI assigned
Sep 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 268506-01 NY Primary

Addresses

Primary practice location

55 Suffolk LN
East Islip, NY 11730-2211

Mailing address

55 Suffolk LN
East Islip, NY 11730-2211
Phone (631) 428-5672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
268506-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1295615656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SUFFOLK LN",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302211",
            "telephone_number": "631-428-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SUFFOLK LN",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302211",
            "telephone_number": "631-428-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTUZELO",
        "first_name": "KERRIANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "268506-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.