Individual provider Active NPI

Nathaniel Krispin, PA-C

  • Physician Assistant
  • Jamaica, NY
National Provider Identifier
1356008536
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13020 Farmers Blvd
Jamaica, NY 11434-4122
Phone
(646) 518-8263
NPI assigned
Nov 22, 2021
Last updated
Nov 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

13020 Farmers Blvd
Jamaica, NY 11434-4122

Mailing address

3721 Carrel Blvd
Oceanside, NY 11572-5911
Phone (516) 209-7685

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112002361 NY Practitioner - Physician Assistant 2264824754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10202 Liberty Ave
Ozone Park, NY 11417-1727
Phone (718) 571-9265

13030 Farmers Blvd
Jamaica, NY 11434-4122
Phone (646) 518-8263

22405 Jamaica Ave
Queens Village, NY 11428-2019
Phone (718) 571-9395

3111 Steinway St
Astoria, NY 11103-3908
Phone (718) 475-2345

6118 188TH St
Fresh Meadows, NY 11365-2713
Phone (718) 489-5003

7049 Austin St
Forest Hills, NY 11375-1033
Phone (718) 280-1245

7425 Grand Ave
Elmhurst, NY 11373-4126
Phone (718) 803-2273

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027707NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Dec 27, 2021 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Dec 27, 2021 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

1345 Rxr Plz
Uniondale, NY 11556
Phone (516) 453-0435

Interoperability endpoints

  • Direct secure messaging: nathaniel.krispin.1@2983.direct.athenahealth.com

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": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1356008536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 CARREL BLVD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115725911",
            "telephone_number": "516-209-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 FARMERS BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114344122",
            "telephone_number": "646-518-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISPIN",
        "first_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.