Individual provider Active NPI

Kristin Fig Mielenhausen, NP

  • Family Nurse Practitioner
  • Southampton, NY
National Provider Identifier
1417398926
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F333954 Issued in NY
Practice address
240 Meeting House LN
Southampton, NY 11968-5009
Phone
(631) 726-3210
Fax
(631) 726-8886
NPI assigned
Jul 12, 2013
Last updated
Feb 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F333954 NY Primary

Addresses

Primary practice location

240 Meeting House LN
Southampton, NY 11968-5009

Mailing address

240 Meeting House LN
Southampton, NY 11968-5009
Phone (631) 726-3210

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
I20140125000280 NY Practitioner - Nurse Practitioner 4688802473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fulton Medical PCGroup PAC ID 8527201540, 19 clinicians

Practice addresses (Care Compare)

60 Queens St
Suite 100
Syosset, NY 11791-3058
Phone (631) 271-9151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F333954NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting House Lane Medical Practice PC CurrentSince Oct 4, 2022 Accepting new patients

Locations

240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

147 Beach Rd
Ste A
Westhampton Beach, NY 11978
Phone (631) 288-7746

Interoperability endpoints

  • Direct secure messaging: kristin.mielenhausen.p8@direct.shproviders.nextgenshare.com

Organizations & group practices 2

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 6

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": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1417398926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LN",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685009",
            "telephone_number": "631-726-3210",
            "fax_number": "631-726-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LN",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685009",
            "telephone_number": "631-726-3210",
            "fax_number": "631-726-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIELENHAUSEN",
        "first_name": "KRISTIN",
        "middle_name": "FIG",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

Verify at the official NPI Registry.