Individual provider Active NPI

Kristin Alfano

  • Physician Assistant
  • Ronkonkoma, NY
National Provider Identifier
1356012280
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
69 Balaton Ave
Ronkonkoma, NY 11779-1744
Phone
(631) 521-5892
NPI assigned
Sep 21, 2021
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

69 Balaton Ave
Ronkonkoma, NY 11779-1744

Mailing address

69 Balaton Ave
Ronkonkoma, NY 11779-1744

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address ffo9004@direct.nyp.org Direct
FHIR URL https://epicproxy-pub/et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20220127001850 NY Practitioner - Physician Assistant 3274925094 Reassigns benefits to 2 organizations

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)

16303 Horace Harding Expy
Fresh Meadows, NY 11365-1449

5620 Main St
Flushing, NY 11355-5046
Phone (718) 670-1837

5626 Main St
Flushing, NY 11355-5046
Phone (718) 670-1185

5634 Main St
Flushing, NY 11355-5046
Phone (718) 670-2468

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Mar 13, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 27, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 27, 2021 Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

1010 N Broadway
Yonkers, NY 10701
Phone (914) 968-3535

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

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

Interoperability endpoints

  • Direct secure messaging: ffo9004@direct.nyp.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1356012280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 BALATON AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117791744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 BALATON AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117791744",
            "telephone_number": "631-521-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFANO",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ffo9004@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct address",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub/et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

Verify at the official NPI Registry.