Individual provider Active NPI

Kristen Joy Clemens, CM

  • Advanced Practice Midwife
  • East Setauket, NY
National Provider Identifier
1316226798
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
6 Technology Drive
East Setauket, NY 11733-9254
Phone
(631) 444-4686
NPI assigned
Aug 16, 2011
Last updated
Jun 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X Primary

Addresses

Primary practice location

6 Technology Drive
East Setauket, NY 11733-9254

Mailing address

6 Technology Drive
East Setauket, NY 11733-9254
Phone (631) 444-4686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120531000550 NY Practitioner - Certified Nurse Midwife (CNM) 8123281185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
State University of New York Downstate Medical Center, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8091
Phone (631) 444-7650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Associates in Obstetrics & Gynecology, University Faculty P CurrentSince May 11, 2019 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

500 Commack Rd
Unit 200
Commack, NY 11725
Phone (631) 638-0140

6 Technology Dr
Setauket, NY 11733
Phone (631) 444-2790

6 Technology Dr
Ste 200
Setauket, NY 11733
Phone (631) 216-8656

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: kristen.clemens@direct.stonybrookmedicine.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1316226798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TECHNOLOGY DRIVE",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117339254",
            "telephone_number": "631-444-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TECHNOLOGY DRIVE",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117339254",
            "telephone_number": "631-444-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENS",
        "first_name": "KRISTEN",
        "middle_name": "JOY",
        "credential": "CM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.